One hundred ninety seven metatarsals of Korean adults were studied macroscopically for the number, position and direction of the diaphysial nutrient foramen. Most metatarsals had on diaphysial nutrient foramen which was situated in the middle third of the shaft with average foraminal index ranging from 43 to 51, but 73% of first metatarsals had two or more foramina. No foramen was observed in 3% of total metatarsals studied. Nutrient foramen was present most frequently on the lateral surface in the first and second metatarsals and on the medial surface in the fifth, but it was present about the same the rate on both medial and lateral surfaces in the third and forth. The direction of the foramen was toward the head in the first metatarsals and toward the basis in the rest being always away from the growing end, thus favoring the growing end theory.
Adult ; Head ; Humans* ; Metatarsal Bones*

Neoplasms of the adrenal cortex are rare in children. Some of them are functioning malignant neoplasms. Two girls with variable degree of virilization and Cushing's sydnrome and a boy with only Cushing's syndrome, which were due to functioning adrenocortical tumors, were presented. All iesions were found in the left adrenal gland. Two of them were histologically adrenocortical calcinoma. There was no histological evidence of malignancy in the oter one in spite of considerable increasing of 24hrs urinary 17 kerosteroid excretion. A review of literature was also made.
Adrenal Cortex ; Adrenal Glands ; Child ; Cushing Syndrome ; Female ; Humans ; Male ; Virilism

During the rehabilitation period, traumatic fracture of the lower extremity in chronic spinal cord injured patients may be occur frequently. In the past, conservative treatment with pillow or plaster splinting was advocated by many clinician, but its treatment is still controversial. This paper presents our experience with fracture of 20 patients(5.7%) of total 350 patients who had spinal cord injuries from Jan. 1980 to Mar. 1987 at Korea Veterans Hospital. The results were as follow. 1. The incidence of fracture was not related to age, sex, type and duration of spinal cord injury. 2. The most common cause of fracture was insignificant trauma(94%). 3. The distribution of fracture was in the following order of frequency;supracondyle of femur (20%), shaft of femur (20%), shaft of tibis (16%). 4. The methods of treatment-Twenty cases were treated by conservative treatment and eleven cases were treated by operative treatment in following order; paster splint with well padded; 9 cases (20%), pillow splint; 4 eases (13%), plate and screw; 3 cases (10%). 5. Total 11 cases of complications were 8 cases in conservative treatment and 3 cases in operative treatment. 6. The duration of bone union was average 10 weeks in nonoperative treatment and average 10.2 weeks in operative treatment. Treatment should strive to achieve fracture healing with minimal danger to the patient and should cause little or no interfrence with patient's daily routine.
Femur ; Fracture Healing ; Fractures, Bone ; Hospitals, Veterans ; Humans ; Incidence ; Korea ; Lower Extremity ; Rehabilitation ; Spinal Cord Injuries ; Spinal Cord ; Splints

OBJECTIVES: A number of investigators have examined the possible pathophysiological mechanisms in patients who died from asthma, but the reasons for the increased incidence of death in patients with asthma are largely unknown. To elucidate the risk factors and possible causes of fatal asthma, we reviewed the clinical data of patients with potentially fatal asthma(PFA). METHODS: We retrospectively studied the clinical and laboratory profiles of 35 PFA patients(43 episodes) who had been admitted at the Kyungpook University Hospital and Taegu Fatima Hospital in recent 5 years(1989. 7-1994. 6). Our criteria of PFA were defined as either respiratory arrest or an arterial carbon dioxide tension(PaCO2) greater than 50 mmHg or an altered state of consciousness, due to acute asthma. RESULTS: 1) Twenty four patients with PFA were female and 11 male. At the time of PFA episode, age distribution was between 16-65 year (42% between 36-49). 2) Seasonal distribution was 13 episodes between March and May, 13 June and August, 6 September and November, 11 December and February. 3) Previous hospitalization history due to asthmatic attack was noted in 81 percent, and 75 percent were relatively compliant to their therapy. 5) At visiting emergency room, 81 percent satisfied the criteria of PFA, whereas 19 percent during hospitalizatoin. 77 percent required mechanical ventilation, and 52 percent of them within 30 minutes after visiting. 6) Initial arterial blood gas analysis at emergency room showed marked hypercapnia(75 +/- 29 mmHg), hypoxemia(50 +/- mmHg) and acidosis(pH 7.14 +/- 0.15). Serum potassium levels were within normal ranges in 75 percent. 7) All, except one, showed no significant cardiac arrthymias. 8) Possible precipitating factors leading to PFA were respiratory tract infection in 31 episodes, ingestion of NSAIDs in 2, emotional upsets in 2, irritant air pollutions in 2, withdrawal of anti-asthma drugs in 1, and unknown causes in 5. 9) Nine of 16 patients were atopic, and majority of them showed positive reaction to Dermatophagoides antigen. CONCLUSIONS: These results may suggest that PFA is mainly due to airway obstruction, and upper respiratory infection is an important precipitating factor leading to PFA. It is necessary to establish an appropriate plan for preventing PFA and related deaths.
Age Distribution ; Air Pollution ; Airway Obstruction ; Anti-Inflammatory Agents, Non-Steroidal ; Asthma* ; Blood Gas Analysis ; Carbon Dioxide ; Consciousness ; Daegu ; Eating ; Emergency Service, Hospital ; Female ; Gyeongsangbuk-do ; Hospitalization ; Humans ; Incidence ; Male ; Potassium ; Precipitating Factors ; Pyroglyphidae ; Reference Values ; Research Personnel ; Respiration, Artificial ; Respiratory Tract Infections ; Retrospective Studies* ; Risk Factors ; Seasons

Intussusception in adults, a rare disease, constitutes approximately 5% of all intussusceptions and accounts for 5% of all cases of intestinal obstruction. In the pathologic findings of the causative lesion, metastatic tumors of the small intestine with intussusception are extremely rare. Because of the high prevalence of underlying lesions in intussusception in adults, surgical management is mandatory. We report two cases of intussusception; one was an adult patient who developed an ileo-ileal type, metastasis from lung cancer, and the other patient was an adult who was developed jejuno-jejunal type, metastasis from a malignant melanoma of the thumb.
Adult ; Humans ; Intestinal Obstruction ; Intestine, Small ; Intussusception* ; Lung Neoplasms ; Melanoma ; Neoplasm Metastasis ; Prevalence ; Rare Diseases ; Thumb

BACKGROUND/AIMS: Recent studies suggest possibility of continuous and prolonged liver ischemia exceeding one hour. We compared mortality rates, liver function, serum Interleukin-6(IL-6) concentration and liver cell necrosis after continuous and intermittent hepatic ischemia in rats. METHODS: Sixty rats were divided into 6 groups to compare 7 day mortality rate. Continuous and intermittent left hepatic inflow occlusion was performed for a total period of 45, 60 and 90 minutes. In a separate study, following 90 minutes continuous or intermittent ischemia, systemic blood was sampled at 0 minute, 6 hours and 24 hours after final clamp release for measurement of SGOT, SGPT and IL-6. Pathologic examination was performed 24 hours or 7 days after reperfusion accordingly. RESULTS: There were no differences in the mortality rates within seven days. There were no differences in the level of SGOT, SGPT and IL-6 between each experimental group. In a pathologic examination, similar liver cell necrosis was found in each group until 24 hours of reperfusion. However, at 7 days after reperfusion, significantly higher grade of hepatic necrosis was noted in the group having continuous ischemia compared with intermittent ischemia of 90 minutes(p<0.05). CONCLUSION: Continuous ischemia is associated with significant risk in the aspect of pathologic study, although it did not affect short term mortality rates.
Alanine Transaminase ; Animals ; Aspartate Aminotransferases ; Interleukin-6 ; Ischemia ; Liver ; Mortality ; Necrosis ; Rats* ; Reperfusion ; Reperfusion Injury*

OBJECTIVE: This study was aimed to characterize the clinical features and course of acute hepatitis A in Korean adults. METHODS: One-hundred and thirteen cases of acute hepatitis A, diagnosed between Jan. 1995 to July 1998 at 6 medical centers in Korea, were reviewed retrospectively. The clinical course of 94 cases with follow-up duration longer than 3 months were analyzed. RESULTS: The median age was 26 (16-65) years and 97.3% of the patients were under 40 years. The presumed sources of infection were identifed in 62 cases (54.9%). Among those, the leading source was ingestion of raw food. All patients showed normalization of bilirubin level within 8 weeks. The ALT levels normalized within 8 weeks in all patients except three patients (3.2%). Three patients with prolonged elevation of ALT showed second rise of ALT, suggesting a possibility of relapsing hepatitis. Prolonged fever (>38 degree C) more than 10 days was observed in 3 patients (3.2%). One case showed prolonged elevation of alkaline phosphatase (> x3 upper normal limit). No case of fulminant hepatic failure or death was observed. CONCLUSION: The majority of cases with acute hepatitis A in Korean adults showed self-limited course with full recovery.
Adult* ; Alkaline Phosphatase ; Bilirubin ; Eating ; Fever ; Follow-Up Studies ; Hepatitis A* ; Hepatitis* ; Humans ; Korea ; Liver Failure, Acute ; Retrospective Studies

BACKGROUND: To estimate bowel patterns in the Korean, we surveyed routine check-up subjects about their bowel habits, using self-reported questionnaire. METHODS: We analyzed 2939 subjects (male 1430, female 1509; age range 25 - 65 years) who had visited health promotion center for routine check-up. Subjects were given a validated self-report questionnaire, which measured the defecation frequency; stool consistency; self-report of constipation; straining to defecate; and levels of laxative use. RESULTS: Of the whole subjects 96.4% had defecation frequency between three per week and three per day. The prevalence of two or less bowel movements per week (4.1% compared to 0.6%), straining to defecate (20.8% compared to 13.0%) and hard stool (18.0% compared to 9.3%) was higher in women than men (p<0.01). The prevalence of self-reported constipation was higher in women than men (9.0% compared to 2.9%, p<0.01). Women were more likely to use laxatives than men (5.5% compared to 0.6%, p<0.01). CONCLUSIONS: Defecation frequency in most of routine check-up subjects is between three per week to three per day. Bowel dysfunction is a greater problem in women.
Constipation ; Defecation ; Epidemiology ; Female ; Health Promotion ; Humans ; Laxatives ; Male ; Prevalence ; Surveys and Questionnaires

Background/Aims: A considerable number of patients with Crohn’s disease still need intestinal resection surgery. Postoperative recurrence is an important issue in Crohn’s disease management, including the selection of high-risk patients. Eastern Asian patients showed several differences from Caucasian patients. Therefore, we investigated the postoperative surgical recurrence outcome and identified risk factors in Korean patients. Methods: Clinical data of 372 patients with Crohn’s disease who underwent first intestinal resection between January 2004 and August 2014 at 14 hospitals in Korea were retrospectively reviewed. Results: Over the follow-up period, 50 patients (17.1%) showed surgical recurrence. The cumulative surgical recurrence rate was 6.5% at 1 year and 15.4% at 7 years. Age under 16 (p=0.011; hazard ratio [HR], 5.136; 95% confidence interval [CI], 1.576 to 16.731), colonic involvement (p=0.023; HR , 2.011; 95% CI, 1.102 to 3.670), and the presence of perianal disease at surgery (p=0.008; HR, 2.239; 95% CI, 1.236 to 4.059) were independent risk factors associated with surgical recurrence. Postoperative thiopurine treatment (p=0.002; HR, 0.393; 95% CI, 0.218 to 0.710) was a protective factor for surgical recurrence. Conclusions Among the disease characteristics at surgery, younger age, colonic location, and perianal lesions were independent risk factors for surgical recurrence. Postoperative thiopurine treatment significantly reduced the incidence of surgical recurrence.

Background/Aims: PF-00547659 is a monoclonal antibody against human mucosal addressin cell adhesion molecule-1 (MAdCAM-1) that prevents the binding of α4β7+ lymphocytes to MAdCAM-expressing sites in the gastrointestinal tract with high affinity and selectivity, and is being developed for the treatment of Crohn’s disease (CD). Methods: OPERA is a randomized, multicenter, double-blind, placebo-controlled study to investigate the efficacy, safety, and pharmacokinetics of PF-00547659 following subcutaneous administration in subjects with active CD, a history of failure or intolerance to anti-tumor necrosis factor and/or immunosuppressants, high-sensitivity C-reactive protein > 3.0 mg/L, and ulcers on colonoscopy. The primary endpoint was Crohn’s Disease Activity Index-70 response at week 8 or 12. Subpopulation analyses for Asian subjects were performed as some differences are observed in genetics and clinical phenotypes in Asian CD patients compared with Western patients. Results: In this study, 265 CD subjects were randomized, with a subpopulation of 21 subjects (8 Japanese and 13 Korean) defined as the Asian population. In the overall and Asian populations; PF-00547659 was pharmacologically active as evidenced by soluble MAdCAM and circulating β7+ central memory CD4+ T-lymphocytes, although no clear evidence of efficacy was observed in any clinical endpoints; pharmacokinetics of PF-00547659 in the Asian subpopulation was generally comparable to the overall population; and the safety profile of PF-00547659 appeared acceptable up to 12 weeks of treatment. Conclusions In the overall and Asian populations, efficacy of PF-00547659 could not be demonstrated using any clinical endpoints compared with placebo. Pharmacokinetics and safety of PF-00547659 were generally comparable. Further studies with larger numbers of patients are required to confirm our results. (Trial Registration Number: NCT01276509)