PURPOSE: To evaluate outcomes after treatment of femoral neck fractures in patients 75 years of age or older. MATERIALS AND METHODS: We reviewed the records of 186 patients 75 years of age or older who underwent bipolar hemiarthroplasty between March 1995 and March 2005 and who were followed for more than two years after surgery. The mean patient age was 84.3 years (range 75~99 years). Forty-eight patients were men, and 138 patients were women. The mean follow-up period was 68.4 months (range 24~113 months). We evaluated the results by analyzing modified Harris hip score, walking ability, activities of daily living, complications, osteoporosis, and radiologic findings. RESULTS: The mean Harris hip score was 89.2 (range 74~95). Walking ability was recovered in 87.6% of cases (163 cases), and activities of daily living were achieved in 85.4% of cases (159 cases). There were 3 cases of acetabular erosion or proximal migration and 3 cases of aseptic loosening in a cemented stem. Thigh pain occurred in 8 cemented stems and in 4 cementless stems. CONCLUSION: We believe bipolar hemiarthroplasty is a useful treatment in elderly patients with femoral neck fractures and severe osteoporosis, especially in view of the stable and rigid fixation of the femoral stem, early ambulation, and the low rate of complications and death, even if the operation is technically very difficult.
Activities of Daily Living ; Aged ; Early Ambulation ; Female ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Hemiarthroplasty ; Hip ; Humans ; Male ; Osteoporosis ; Thigh ; Walking

PURPOSE: Atopic Dermatitis (AD) is a chronically relapsing inflammatory skin disease. Generally, aeroallergens and food allergens can exacerbate symptoms in AD. Currently they are divided into two groups: one is an IgE mediated form and the other is a non-IgE mediated form. This study focused upon clinical manifestations of two distinct forms of AD. METHODS: We evaluated 110 patients (male: 58, female: 52) with AD. All patients had visited Masan Samsung Hospital from June 2002 to February 2005. The patients were divided into 2 sub-groups according to their serum total IgE and specific IgE levels. The serum total IgE and specific IgE to Dermatophagoides pteronyssinus, Dermatophagoides farinae, Egg white, Cow's milk and Soybean were measured by the Pharmacia CAP-FEIA system. Metacholine provocation tests were conducted to reveal bronchial hyper-responsiveness and ARIA guidelines for diagnosis of AR were applied. RESULTS: Our study showed more female predominance in non IgE-mediated atopic dermatitis patients and showed higher total eosinophil count in IgE-mediated atopic dermatitis. (P< 0.05) There was no difference in frequency of asthma between two groups (P> 0.05), but allergic rhinitis was significantly predominant in non IgE-mediated atopic dermatitis patients. (P< 0.05) CONCLUSION: Female was more predominant in non IgE-mediated atopic dermatitis patients and IgE-mediated atopic dermatitis patients showed higher total eosinophil count and more frequency of allergic rhinitis.
Allergens ; Asthma ; Child* ; Classification* ; Dermatitis, Atopic* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Diagnosis ; Egg White ; Eosinophils ; Female ; Humans ; Hypersensitivity, Immediate ; Immunoglobulin E* ; Milk ; Rhinitis ; Skin Diseases ; Soybeans

PURPOSE: To evaluate the radiological and clinical outcomes of the operative treatment for the unstable distal radius fractures with displaced ulnar styloid process fractures. MATERIALS AND METHODS: From 2002 to 2005, 17 patients with unstable distal radius fractures with displaced ulnar styloid process fractures were treated operatively, using external fixation or internal fixation for distal radius and open reduction with tension band wiring for ulnar styloid process fractures. We evaluated postoperative outcomes with Mayo wrist score, range of motion, ulnar side wrist pain, wrist stress test, grip strength as well as radiological evaluation. RESULTS: All ulnar styloid process fractures were completely united, and according to Mayo wrist score, 7 cases(41%) were excellent, 8 cases(47%) were good. 14 cases(82%) had no ulnar wrist pain and 15 cases(88%) had grip strength more than 50% when compared with the normal side. Posterior instability of ulnar head occurred at 1 case. CONCLUSION: We got acceptable clinical and radiological results of operative treatment of ulnar styloid process fractures and concluded that ulnar styloid process fractures combined with distal radius fractures should be carefully evaluated and treated operatively according to their fracture types.
Exercise Test ; Hand Strength ; Head ; Humans ; Radius ; Radius Fractures ; Range of Motion, Articular ; Wrist

Purpose: This study was conducted to explore the healthcare experience of residents participating in the CommunityBased Hypertension and Diabetes Registry Program. Methods: This study used qualitative content analysis. Data were collected from in depth interviews of fifteen participants, who either participated in the program hosted by the Training Center for Hypertension and Diabetes for more than two years or participated in an intensive one-on-one education program. Results: The results showed that the core theme in healthcare of participants was ‘Proactive healthcare with attention and systematic guidance of experts’. The positive reinforcement of staffs and the improvement of self-efficacy through effective close management were found to be positive influencing factors of participation. The theme consisted of the following categories: ‘Participation in the program with positive expectations on healthcare’, ‘Interest in body and health’, ‘Vitality in life’, ‘Confidence in dealing with disease’, ‘Thankfulness for close care and attention’, and ‘Desire for continuous care’. Conclusion When establishing policies on managing chronic diseases, a strategy that reflects the results of the study is required. It is necessary to build up emotional relationship among stakeholders, and expand opportunities for close healthcare such as one-on-one customized training, and mutual cooperation with various organizations in the local community.

PURPOSE: We wanted to evaluate the clinical features after treating of bilateral sequential hip fractures in the elderly. MATERIALS AND METHODS: We reviewed the clinical records of 21 patients who were older than 75 years and who underwent bilateral bipolar hemiarthroplasty for sequential hip fractures between March 1999 and November 2005. The minimum follow up period was 2 years. We analyzed the results by conducting radiological and clinical evaluations such as assessing the patient's walking ability, the activities of daily living, the mechanism of fracture and the associated medical conditions and arthritis. RESULTS: Walking ability was recovered by 18 cases of primary fracture and by 14 cases of sequential fracture. Return to the activities of daily living was achieved by 14 cases of primary fracture and by 14 cases of sequential fracture. The fracture mechanism was a fall/slip in 20 cases and a fall from a height in 1 case. The associated arthritis was in the spine in 14 cases, the knee in 11 cases, the shoulder in 8 cases and Hallux valgus in 5 cases, and the associated medical conditions were mainly urge incontinence in 17 cases and cardiovascular disease in 16 cases. The other previous fractures were spine compression fracture in 11 cases, ankle fracture in 6 cases, distal radius fracture in 5 cases and pelvic ramus fracture in 2 cases. CONCLUSION: Preventing recurrent falls plays a role in preventing bilateral sequential hip fractures. We think that the treatment of curable associated medical conditions and arthritis is necessary to prevent recurrent falls.
Activities of Daily Living ; Aged ; Animals ; Ankle ; Arthritis ; Cardiovascular Diseases ; Follow-Up Studies ; Fractures, Compression ; Hallux Valgus ; Hemiarthroplasty ; Hip ; Hip Fractures ; Humans ; Knee ; Radius Fractures ; Shoulder ; Spine ; Urinary Incontinence, Urge ; Walking

BACKGROUND/OBJECTIVES: Papillary thyroid carcinoma (PTC) has generally an indolent character with a good prognosis. However, recurrence remains a major concern for the patients during their lifetime. Despite the slowly progressing character of PTC, recurrence can occur within a short period after initial surgery.This study aimed to determine the clinical findings and cause of recurrence in patients who underwent re-operative surgery due to neck node recurrence by reviewing the CT (computed tomographic) scan imaging of the recurrence of PTC retrospectively.MATERIALS #SPCHAR_X0026; METHODS: We reviewed the medical records of patients referred to Ajou University Hospital from January 2002 to January 2018. All patients had re-operative surgery due to neck node recurrence and CT scan results of preoperative evaluation and postoperative follow up. Over this period, 110 patients who underwent re-operation due to neck node recurrence with a CT scan were included in our cohort, resulting in a total of 220 re-operations.RESULTS: The time from initial operation to first re-operation was examined in 110 patients. The median time to re-operation was 28 months, with a range of 4 months to 186 months. Most re-operations (82.7%) occurred within the first five years, 43.6% were in the first two years from the initial surgery. The result of the retrospective CT review showed newly developed cases (21,19.1%), missed diagnosis cases (42,38.2%), real recur cases after surgery (33,30.0%), and remnant lymph nodes (LNs) cases (14,12.7%). We further sub-analyzed 14 cases with remnant LNs. Reasons for remnant LNs included insufficient operation (N=5) and beyond general surgical extent. (N=9).CONCLUSION: Re-operation due to cervical lymph node recurrence is mostly a persistent disease. They included a missed diagnosis and incomplete operation. These finding may reduce the reoperation of cervical lymph node recurrence by accurate preoperative evaluation and complete surgical resection at the initial surgery.
Cohort Studies ; Diagnosis ; Follow-Up Studies ; Humans ; Lymph Nodes ; Medical Records ; Neck ; Prognosis ; Recurrence ; Reoperation ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Tomography, X-Ray Computed

OBJECTIVES: The research was aimed at analyzing the contents of university intranet for systematically execution of the healthy information provision and healthy consultation services from 2000 January to 2004 December. METHODS: We have analyzed 300(28.3%) the instances of accomplished health consultation cases from the whole 1,059 instances which were the replied in a university intranet. RESULTS: According to the contents of health consultation in ICPC code, a general symptom 91 cases(30.3%) was most, muscle-skeletal system 44 cases(14.7%), and digestive system 43 cases(14.3%) in order of cases of health counselling. The symptoms and complaint with 155 cases(51.7%) were most in the distribution of the health counselling contents by 17 charter of ICPC. The most common reason of counselling by 17 charter of ICPC were as follows; questions about the symptom and diagnosis(118 cases, 39.3%), the preventive and treatment methods(91 cases, 30.0%), and medical fee(20cases, 6.7%) in order. We mainly answer on the content of health counselling were as follows; make an offer of medical information and knowledge(48.3%), recommend visit clinic or hospital(23.7%), guide to treatment(12.7%), and so on. CONCLUSIONS: This research showed that the program of health counselling may not meet completely the high quality and adequate distribution of health counselling by the intranet in a university by content analysis. The finding suggests that health counselling by intranet in a university may be used to supplement of systemic improvement on the intranet Q/A format from current lack of essential health information and security for the quality of the health counselling.
Computer Communication Networks* ; Counseling* ; Digestive System

PURPOSE: The purpose of this study was to identify the factors that influence the functional status of patients with heart failure. METHOD: A descriptive, correlational study design was used. The participants in this study were 260 patients with heart failure who were admitted at Y University and U University in Seoul, Korea. Between September 2005 and December 2005 data was collected by an interview using a questionnaire and from medical records. The Functional status was measured with KASI. Physical factors (dyspnea, ankle edema, chest pain, fatigue, and sleep dysfunction), psychological factors (anxiety and depression), and situational factors (self-management compliance and family support) were examined. RESULT: In general, the functional status, anxiety, depression, self-management compliance, and family support was relatively not good. The level of fatigue was highest and the level of ankle edema was lowest for physical symptom experiences. In regression analysis, functional status was significantly influenced by dyspnea(23%), age(13%), monthly income(7%), fatigue(3%), ankle edema(2%), depression(1%), and length of stay in the hospital(1%). These factors explained 50% of the variables in the functional status. CONCLUSION: These results suggest that psycho-physiological symptoms management should be a focus to improve the functional status in patients with heart failure.
Affective Symptoms ; Aged ; Aged, 80 and over ; Female ; Health Status ; Heart Failure/*diagnosis/*psychology ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Patient Compliance ; Psychology ; Questionnaires ; Sickness Impact Profile ; Socioeconomic Factors

BACKGROUND/AIMS: Mesenchymal tumors are the most frequent submucosal tumors in gastrointestinal trail. We reviewed the mesenchymal tumors which are confirmed by pathology to examine whether the invasive approach of all mesenchymal tumors is necessary. METHODS: This study was performed on fifty-nine patients who has mesenchymal tumors confirmed by endoscopic or surgical resection from January 2000 to June 2004. RESULTS: Mesenchymal tumors consisted of thirty-six gastrointestinal stromal tumors (GISTs), 20 leiomyomas and 3 schwannomas. All the esophageal tumors were leiomyoma (12/12, 100%). In stomach, there were 32 GISTs (76.2%), 7 leiomyomas (16.7%) and 3 schwannomas (7.1%). And there were 4 GISTs (80.0%) and 1 leiomyoma (20.0%) in duodenum. Tumors less than 1 cm in maximal diameter were leiomyoma or GISTs with very low risk of aggressive behavior. 56.1% of the tumors larger than 1 cm consisted of low, intermediate or high risk GISTs. CONCLUSIONS: Biopsy must be considered according to its size and anatomic location of mesenchymal tumors. The invasive approach for every esophageal submucosal tumor is not necessary unless the size is very large, because most of them are benign in nature. However, the gastric submucosal tumor with more than 1 cm in diameter should be carefully and regularly followed up or biopsied because it cannot be assumed to be benign for any GIST more than 1 cm in size at the present time, safely.
Adult ; Aged ; *Biopsy, Needle ; Endoscopy, Gastrointestinal ; Female ; Gastrointestinal Neoplasms/*pathology ; Gastrointestinal Stromal Tumors/*pathology ; Humans ; Leiomyoma/pathology ; Male ; Middle Aged ; Neurilemmoma/pathology ; Upper Gastrointestinal Tract

PURPOSE: Traditional transcutaneous incision and transconjunctival incision methods are commonly used in the lower blepharoplasty. The transconjunctival method leaves no visible scars nor does it change the shape of lower eyelid contour and the surgical technique is not difficult. However removal of excess baggy skin is not possible through this method. Therefore, the transconjunctival incision method is useful only for patients who still have normal elasticity of the lower eyelids and fat that is protruding only anterocaudally. The Author will introduce a technique, which complements the limitations of these two methods mentioned above. METHODS: The author combined the transconjunctival approach and lower blepharoplasty with only the excised skin flap method. This method does not go beyond the previous methods but does apply the advantages of them. RESULTS: From March 2007 to October 2010, this new technique was performed in a total of 62 patients. Fat was removed and repositioned through transconjunctival incision. Drooped skin was excised as in the traditional blepharoplasty but only the skin flap was elevated. This prevents post-operative complications such as ectropion, sclera show, and deformation of the shape of the lower eyelids or under-resection of fat. All patients were satisfied with the post-operative appearance. CONCLUSION: The author was able to get satisfactory results while avoiding complications of traditional transcutaneous technique with this combined technique of the transconjunctival approach and the lower blepharoplasty method of skin flaps only.
Blepharoplasty ; Cicatrix ; Complement System Proteins ; Ectropion ; Elasticity ; Eyelids ; Humans ; Sclera ; Skin