To study the development of distraction at the fracture site according to inaccurate insertion of the distal screw in treatment of femoral shaft fracture with interlocking intramedullary nail, we prepared 24 femoral bone model, fixed them with interlocking intramedullary nails after artificially making transverse fracture or spiral fracture at mid 1/3 of femoral shaft and distal 1/3 of femoral shaft. The cephalocaudal insertion angles of the distal screws ranged from 5.2 to 45.4. As the insertion angles increased, the distances between the fractured sites ranged from 0.1 to 8.2mm. Distractions splited more than 5mm were seen in the average insertion angle of 34.3+/-9.4 (28.2 -45.4 ). When the insertion was made few millimeter proximal from the center of the distal screw hole, which was parallel to the transverse section of the femur model, fracture distraction ranged from minimum 1.8mm to maximum 5.0mm. In conclusion, the cephalocaudal insertion angle or location of the distal screw can be reason for the distraction between the fractured sites in internal fixation with intramedullary nail in long bone like femur. To prevent the distraction of fractured site, it is important to make the insertion of the distal screw parallel to the transverse section of the femur and to insert into the center of the screw hole.
Femur ; Fracture Fixation, Intramedullary*

Tinea capitis in adults, especially healthy, is known to be rare but a significant increase in case has recently been observed. Trichophyton rubrum is an anthropophilic, the commonest dermatophyte affecting man but rarely involves the scalp and hair. We describe a 63-year-old healthy woman with tinea capitis due to T. rubrum who has clinical improvement after oral terbinafine therapy.
Adult* ; Arthrodermataceae ; Female ; Hair ; Humans ; Middle Aged ; Scalp ; Tinea Capitis* ; Tinea* ; Trichophyton*

Trichoblastoma is a rare benign neoplasm that arises in the follicular germinative cells. The terminology and histopathological definition of this tumor is both complex and confusing. Trichoblastoma occurs only on the hair bearing areas such as the scalp, face and pelvic area with varying degrees in size. We describe a case of trichoblastoma occurring as a nodule on the nose. The tumor was composed of numerous lobules of basaloid epithelial cell nests with distinct peripheral palisading of nucleoli that were clearly demarcated from the stroma.
Epithelial Cells ; Hair ; Nose ; Scalp

No abstract available.
Histiocytoma*

Large-cell acanthoma is a generally hyperkeratotic, sharply demarcated patch on sun-exposed skin with the outstanding pathologic feature being composed of large, relatively uniform keratinocytes. We describe a case of large-cell acanthoma that involved the skin of the nasal bridge. Patient was a 56-year-old women with a tannish brown patch, 2 cm in size and of 5 years' duration. Controversial issues about nosologic entity of large cell acanthoma are discussed.
Female ; Humans

Vascular leak syndrome(VLS) is characterized by endothelial damage, which causes extravasation of plasma proteins and fluid from capillaries into the extravascular space. It has been suggested that the increased vascular permeability is the result of an IL-2-induced suppression of endothelin-1 secretion by endothelial cells, an IL-2-induced activation of the complement cascade or TNF-alpha release from IL-2-activated T-cells. A 13-year-old male patient visited our hospital with abdominal pain. He was diagnosed with acute lymphoblastic leukemia(T cell type) by bone marrow study on his 2 nd day in hospital. On the 3 rd day of induction chemotherapy(prednisone, L-asparaginase, vincristine, intrathecal methotrexate), pulmonary edema and pleural effusion, ascites and generalized edema developed and lasted for 53 days without responding to supportive care. The laboratoy finding was that TNF-alpha was increased without evidence of infection and hypoalbuminemia was noted. It was suggested that the patient's clinical feature was induced by VLS.
Abdominal Pain ; Adolescent ; Ascites ; Blood Proteins ; Bone Marrow ; Capillaries ; Capillary Permeability ; Complement System Proteins ; Edema ; Endothelial Cells ; Endothelin-1 ; Humans ; Hypoalbuminemia ; Induction Chemotherapy* ; Male ; Pleural Effusion ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Pulmonary Edema ; T-Lymphocytes ; Tumor Necrosis Factor-alpha ; Vincristine

PURPOSE: The purpose of this study was to examine cognitive functions, depression, and life satisfaction among the elderly receiving visiting nursing services. METHODS: The subjects of this study consisted of 221 elderly individuals who were receiving visiting nursing services from a public health center located in Gyeonggi-do. The Mini-mental State Examination Korea version (MMSE-K), Geriatric Depression Scale-short form-Korea version (GDS-K), and Life Satisfaction Scale were utilized to determine cognitive functions, depression, and life satisfaction. Collected data was analyzed by the SPSS PC Win 12.0 program. RESULTS: The prevalence of cognitive impairment (MMSE-K< or =24) was 86.4%, and the proportion of severe depression (GDS-K> or =10) was 22.6%. Older age, lower education, and low income were associated with cognitive impairment, and low education, no religion, and low income were associated with depression. Cognitive function negatively correlated with depression. Life satisfaction level was fairly low and was not associated with any variables. CONCLUSION: The high prevalence of cognitive impairment and low life satisfaction status were determined among low-income elderly who were registered at a visiting health care center. Thus, in the future at visiting health care services, efficient and various programs for the elderly should be tried, to improve cognitive functions and reduce depression. Additionally, consistent evaluation studies for those programs will be required.
Aged ; Aged, 80 and over ; Cognition Disorders/*epidemiology ; Community Health Nursing/organization & administration ; Depression/*epidemiology ; Female ; Humans ; Male ; Middle Aged ; *Personal Satisfaction ; Quality of Life ; Questionnaires

PURPOSE: Congenital hypothyroidism(CH) is not uncommon disorder, leading to retardation of mental development and growth, if not treated early. The aim of this study is to determine the factors influencing IQ of children with CH, diagnosed after 1 month of life. METHODS : Thirteen children with CH were included. They had intelligence test by KEDI-WISC(Korean Educational Development Institute-Wechsler Intelligence Scale for Children) and their medical records were reviewed. Their T4, TSH, height, age at diagnosis were investigated retrospectively. To evaluate the influence of T4, TSH, height, age at diagnosis on IQ, children were divided into three groups ; athyroid(n=8), sublingual(n=3), inborn errors of thyroid hormone synthesis(n=2) according to the result of thyroid scan. Results : In athyroid group, IQ closely correlated to VIQ and PIQ and had close relationship to T4 at diagnosis(.p=0.0086, r=0.8427), but no relation to TSH. There was no difference in height, T4 TSH, and IQ between athyroid and sublingual group. CONCLUSION : The results suggest that intellectual function in children with CH, diagnosed after 1 month of life depends on serum level of T4 at diagnosis. Further study is mandatory to elucidate the relationship between final IQ and factors, including thyroid function, age at diagnosis, adequacy of treatment, etc.
Child* ; Congenital Hypothyroidism* ; Diagnosis ; Growth and Development ; Humans ; Intelligence ; Intelligence Tests ; Medical Records ; Retrospective Studies ; Thyroid Gland

No abstract available.
Echocardiography* ; Echocardiography, Doppler, Pulsed ; Heart Diseases* ; Heart*

Verrucous carcinoma is a slow growing, low grade squamous cell carcinoma, which usually occurs on oropharynx, genitalia and soles. When it occurs on feet, it is known as epithelioma cuniculatum. Epithelioma cuniculatum is characterized by its histologic sinuses and cystic formations in a cuniculate(rabbit burrow-like) pattern. A 59-year-old man was consulted to our department for a well circumscribed, 5 × 5 cm sized, round, hyperkeratotic, verrucous plaque on the right great toe. He suffered from diabetes mellitus for 16 years and was managed by peritoneal dialysis three times a week due to chronic renal failure for last two years. The plaque had gradually increased in size. The biopsy specimen taken from the tumor mass showed chronic ulcerative inflammation with atypical squamous cell proliferation. We herein report a case of verrucous carcinoma occurring in a patient with diabetes melli-t tus and chronic renal failure.
Biopsy ; Carcinoma ; Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Cell Proliferation ; Diabetes Mellitus* ; Foot ; Genitalia ; Humans ; Inflammation ; Kidney Failure, Chronic* ; Middle Aged ; Oropharynx ; Peritoneal Dialysis ; Toes ; Ulcer