No abstract available.
Lichens* ; Mucinosis, Follicular*

Fracture of the tibial shaft is one of the most common fractures of the long bones and frequently followed by malunion, delayed union and nonunion. We experienced the cases of further increase in the angulation after clinical union of the tibial shaft fractures treated by conservative method. So we analyzed 39 cases of tibial shaft fractures which were followed up from 12 weeks to 37 weeks after clinical union in adults. The results were as follows; l. 7 of the 39 cases(18%) showed the increase in the angulation, and all of them were male. 2. Increase in the angulation occurred more frequenlty in the comminuted fractures than simple fractures. 3. The increment of angulation was more marked in group of patients with higher angulation at the time of clinical union. 4. Increase in the angulation occurred more commonly in the cases not associated with fibula fracture than in the cases associated with fibula fracture. 5. Further increase in the angulation was less common in the cases in whom early weight bearing with PTB cast was started.
Adult ; Fibula ; Fractures, Comminuted ; Humans ; Male ; Methods ; Tibia ; Weight-Bearing

Pseudohypoparathyroidism(PHP) is a genetic disorder characterized by target cell resistance to the effect of parathyroid hormone(PTH). The disorder is classified into type I a, I b, I c and II depending on the phenotype and biochemical findings. In type I a, urinary cyclic AMP and urinary phosphate excretion are not increased after PTH stimulation because of deficient G unit activity in target cells. Deficiency of the G unit is a generalized cellular defect and accounts for the association of other endocrine disorders with type I a PHP. Type I b PHP shows resistance to PTH but not to other hormones and normal phenotypic appearance. In type I c PHP affected children have defect in catalytic unit of adenylate cyclase and in addition to resistance to PTH, resistance to the metabolic effects of TSH, gonadotropins, and glucagon may be detected. Typical appearance of Albright's hereditary osteodystrophy is common in PHP type Ia and Ic. In type II PHP, urinary cyclic AMP response is generated but this does not lead to phosphaturia. We experienced two patients with PHP. One is a 11-year-old girl diagnosed type I a PHP and the other is a 11-year-old boy suspected type I b PHP. They visited emergency room because of tetanic movement. Both patients had no previous history of tetany and showed low serum calcium level, high phosphorus level and high PTH level. The girl had typical features of Albright's hereditary osteodystrophy such as round face, short neck, obese feature, brachydactyly and mental retardation but didn't have basal ganglia calcification on brain CT. The boy showed normal appearance and no mental retardation.
Adenylyl Cyclases ; Basal Ganglia ; Brachydactyly ; Brain ; Calcium ; Child ; Cyclic AMP ; Emergency Service, Hospital ; Female ; Glucagon ; Gonadotropins ; Humans ; Hypophosphatemia, Familial ; Intellectual Disability ; Male ; Neck ; Phenotype ; Phosphorus ; Pseudohypoparathyroidism* ; Tetany

BACGROUND: The purpose of this study was to evaluate the efficacy of caudal epidural steroid injection with local anesthetic for chronic lower back pain patients. METHODS: The 152 patients with lower back pain were selected for the study. The patients were treated with the caudal injections of steroid (triamcinolone acetate 40 mg) and local anesthetics (1% lidocaine 17 ml). The efficacy of caudal injections was assessed with the visual analogue scale (VAS) before procedure and at 8 weeks following procedure. RESULTS: The VAS scores of 'Before procedure' group and '8 weeks after procedure' group were 62 23 and 31 15, respectively. The caudal steroid injections provided effectiveness in treating various lower back pain diseases except postlaminectomy syndrome. CONCLUSION: We consider that caudal epidural injections of steroid and local anesthetics are effective for patients with chronic lower back pain in the short term.
Anesthetics, Local ; Humans ; Injections, Epidural ; Lidocaine ; Low Back Pain*

BACKGROUND: In general, the outcomes of arthroscopic repair for superior labrum anterior to posterior lesions (SLAP) are favorable, however, persistent pain and limitation of motion are not rare complications. One of the possible cause is a “knot-ache”. This study evaluated the results of reoperation of symptomatic recurrent SLAP lesions and asked whether the knot is associated with postoperative complications. METHODS: Between 2005 and 2015, a total of 11 patients who had undergone arthroscopic SLAP repair were reoperated for recurrent symptomatic SLAP lesion. By retrospective chart review, operative findings, the visual analogue scale for pain (pVAS), the range of motion (ROM), and functional scores were analyzed. RESULTS: The mean age of the study participants was 38.3 years, and the mean follow-up period was 42.5 months. In the primary operation, there were nine cases of repairs with conventional knot-tying anchors and three cases with knotless anchors. Impingement of the knots during abduction and external rotation of the shoulder was observed in the all cases with knot-tying anchors. The mean pVAS, ROM, and functional scores significantly improved with reoperation. At the final follow-up, the mean satisfaction VAS was 8.3. CONCLUSIONS: The knots of suture anchor maybe a possible etiology of the pain, which we termed a “knot-ache”. Considering that reoperation is performed due to pain after primary repair, the use of knotless suture anchor may have benefits of eliminating one of possible cause, “knot-ache”. Therefore, authors suggest the use of knotless anchors during reoperation for recurrent or recalcitrant pain after primary SLAP repair.

Multi-drug resistant tuberculosis is an emerging threat to humans. Despite steady efforts of the national tuberculosis control program, current prevalence of multi-drug resistant tuberculosis rate is increasing in Korea. In Korea, it is effective to both improve the medical transfer system on tuberculosis, and also to make a new tuberculosis patient control system with integrated public-private sector. Improvement focused on the new medical transfer system is a suitable model considering current situation of the Korean medical system. This model can be achieved by replacing the traditional drug susceptibility test method, which requires a long turnaround time, with rapid molecular biological method, and improving the overall process of specimen transport system, report system, and guidelines for tuberculosis, as well. Using such model, doctors can discover multi-drug resistant tuberculosis patients at an earlier stage, prescribe appropriate drugs at the right time, and effectively support directly observed treatment short course strategy. Therefore, this new model for improvement of multi-drug resistant tuberculosis control program, medical transfer system-focused public-private integrated system, can present an effective tool for enhancing and modifying functions of the current national tuberculosis programme in Korea.
Humans ; Korea ; Prevalence ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

41 patients with hyperlipidemia(Serum cholesterol > or =260mg% or triglyceride> or =200mg%) were treated for 12 weeks each with either Bezafibrate(200mg t.i.d.)(n=23) or placebo(n=18) in a randomized trial. Compared with placebo, Bezafibrate was more effective in lowing total cholesterol(287+/-63 to 244+/-32 mg%, P<0.01), LDL-cholesterol(183+/-39 to 153 +/-25mg%, P<0.01) and the LDL/HDL ratio(4.7+/-2.9 to 3.4+/-1.3, P<0.05). There was also a marked reduction in serum triglyceride(307+/-295 to 218+/-167mg%, P<0.05) as well as a significant increase in HDL-cholesterol(43+/-12 to 48+/-12mg%, P<0.05). Compliance or tolerance to both Bezafibrate and placebo was good. No significant side effects except one case, who complained of mild indigestion, were observed. Therefore, Bezafibrate seemed to be effective in lowing serum total cholesterol, LDL-cholestrol, triglyceride and in increasing in HDL-cholesterol without significant side effect.
Bezafibrate ; Cholesterol ; Compliance ; Dyspepsia ; Humans ; Hyperlipidemias* ; Triglycerides

The incidence of heterotopic gastric mucosa located in the submucosa in resected stomach specimens has been reported to be 3.0 to 20.1%. Heterotopic gastric mucosa is thought to be a benign disease, which rarely becomes malignant. Heterotopic gastric mucosa exists in the gastric submucosa, and gastric cancer rarely occurs in heterotopic gastric mucosa. Since tumors are located in the normal submucosa, they appear as submucosal tumors during endoscopy, and are diagnosed through endoscopic biopsies with some difficulty. For such reasons, heterotopic gastric mucosa is mistaken as gastric submucosal tumor. Recently, two cases of early gastric cancer arising from heterotopic gastric mucosa in the gastric submucosa were treated. Both cases were diagnosed as submucosal tumors based on upper gastrointestinal endoscopy, endoscopic ultrasound, and computed tomography findings, and in both cases, laparoscopic wedge resections were performed, the surgical findings of which also suggested submucosal tumors. However, pathologic assessment of the surgical specimens led to the diagnosis of well-differentiated intramucosal adenocarcinoma arising from heterotopic gastric mucosa in the gastric submucosa.
Adenocarcinoma ; Biopsy ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastric Mucosa ; Incidence ; Stomach ; Stomach Neoplasms

The P wave during orthodromic atrioventricular reentry tachycardial were analysed in 19 patients to evaluate the usefulness in identifying the location of accessory pathways. The results were as follows; 1) Definitely inverted and upright P waves in lead I represented the left-sided and right-sided pathways respectively, but the converse is not necessarily true. 2) Dome and Dart appearance in lead VI(4 cases), upright P wave in inferior leads(3 cases), and negative P wave in aVL(3 cases) suggested the left-sided pathway and deeply inverted P waves in inferior leads suggested the posteroseptal or right-sided one. 3) In 17 cases(79%), inverted P wave appeared on more than one lead among the inferior leads, which were helpful to identify the position on P wave and mechanism of supraventricular tachycardia. Although the number of cases especially with right-sided pathway was small to conclude, P wave was useful for determining the location of accessory pathway noninvasively.
Humans ; Tachycardia* ; Tachycardia, Supraventricular

Hidroacanthoma simplex is a benign tumor believed to arise from the uppermost segment of the intradermal eccrine duct and the acrosyringium, and histologically shows intraepidermal focal growth. A malignant counterpart to this tumor is rare and named malignant hidroacanthoma simplex or porocarcinoma in situ. We report a case of atypical hidroacanthoma simplex, which is considered to be a malignant transformation of benign hidroacanthoma simplex in a 83- year-old female.
Female ; Humans ; Immunohistochemistry