BACKGROUND: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. METHODS: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. RESULTS: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were 156.7°, 152.2°, 61.1°, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. CONCLUSIONS: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.
California ; Elbow ; Follow-Up Studies ; Humans ; Humerus* ; Joint Capsule Release ; Methods ; Postoperative Complications ; Shoulder ; Surgeons ; Suture Anchors ; Sutures

Hypothalamic suprachiasmatic nucleus (SCN) is a circadian pacemaker which controls diurnal behavioral and hormonal rhythms in mammals. The SCN receives environmental light signals through the retinohypothalamic tract, and glutamate is the major excitatory neurotransmitter in the retinohypothalamic tract. In the present study, we investigated the developmental expression of the mRNAs for N-methyl-D-aspartate type glutamate receptor (NR)1, NR2A, NR2B and NR2C subunits in the rat SCN using in situ hybridization with specific riboprobes. At postnatal day 2 (P2), P8, Pl5 and P45, the high level of NRI transcripts was observed in both ventrolateral and dorsomedial subdivisions of the SCN, and the distinct expression of NR2C mRNA was principally found in the dorsomedial SCN. The weak NR2B mRNA expression was clearly found in both subdivisions of the SCN at P2 and P8, whereas specific NR2B hybridization signals were not found at Pl5 and P45. There was no specific hybridization signal of NR2A in the SCN throughout the postnatal life. These findings implicate that NR may play an important role in the neonatal SCN. In addition, this study suggests that NR1, NR2B and NR2C might be the major NR subunits in the developing SCN, whereas NRI and NR2C could be the subunit components of NR in the adult SCN.
Adult ; Animals ; Glutamic Acid ; Humans ; In Situ Hybridization ; Mammals ; N-Methylaspartate* ; Neurotransmitter Agents ; Rats* ; Receptors, Glutamate ; RNA, Messenger* ; Suprachiasmatic Nucleus

Intramedullary nailing is the treatment of choice for most diaphyseal fractures of the tibia. The purpose of this study is to evaluate the result of tibia fractures treated with interlocking intramedullary nail, according to different sites of fractures. From september 2004 to august 2012, 106 cases of tibia fracture with a minimum follow up until bony union were selected and analyzed retrospectively. The mean follow-up period of the patients was 24.5 months. The location of fractures were divided into three groups, proximal (n = 18), mid (n = 42), distal (n = 46). Delayed union, mal-alignment and additional operation were investigated. The number of angle change over 5 degrees in the coronal plane and 10 degrees in the sagittal plane were 7 cases in proximal, 7 cases in mid, and 12 cases in distal with statistic significance. And an additional operation was required in 6 patients in proximal fracture, 2 patients in mid fracture, and 7 patients in distal fracture during bony union. Conclusively, intramedullary nailing in proximal and distal tibia fracture showed higher delayed union rate and could result in excessive angle change due to mal-alignment. Therefore, proximal level or distal level tibia fractures need more accurate reduction of fracture than midshaft level would need more accurate reduction of fracture and observe bony union through regularly radiography examination.
Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Radiography ; Retrospective Studies ; Tibia*

OBJECTIVE: This study was designed to describe the trends in body mass index (BMI) during 6 years (2002 - 2008) and to identify associations between these trends and the amount of physical activity of South Korean career soldiers. METHOD: This study targeted the 40 993 (38 857 men and 2136 women) of the 58 657 career soldiers who had undergone four (2002, 2004, 2006, and 2008) biennial medical examinations conducted by the National Health Insurance Corporation; 17 664 soldiers with missing data on height, weight, and physical activity were excluded. A linear mixed-regression model was used to categorize changes in BMI due to age versus those due to amount of physical activity. RESULTS: Career soldiers experienced significant increases in BMI compared with baseline data gathered in 2002. The increases in each age group were as follows: men aged 20- 29: 1.16, men aged 30 - 39: 0.61, men aged 40 - 49: 0.05, women aged 20- 29: 0.35, women aged 30- 39: 0.30, women aged 40-49: 0.26, and women aged 50- 59: 0.21. However, men aged 50 or older showed significant decreases (as high as 0.5) in BMI compared with baseline data obtained in 2002. They also experienced significant decreases in BMI compared with those who reported no physical activity. The differences between baseline and final BMIs were: 0.02 for men exercising 1- 2 times per week, -0.07 for men exercising 3-4 times per week, -0.19 for men exercising 5-6 times per week, -0.21 for men exercising seven times per week, -0.05 for women exercising 1- 2 times per week, -0.19 for women exercising 3- 4 times per week, -0.30 for women exercising 5-6 times per week, and -0.30 for women exercising seven times per week. CONCLUSIONS: Obesity in South Korean career soldiers increased markedly between 2002 and 2008, and our data showed that the amount of physical activity was inversely related to increases in BMI. Policies to prevent obesity are needed to reduce this trend.
Adult ; *Body Mass Index ; Female ; Humans ; Male ; Middle Aged ; Military Personnel/*statistics & numerical data ; *Motor Activity ; Obesity/diagnosis ; Regression Analysis ; Republic of Korea

No abstract available.
Addison Disease*

Purpose: This study evaluated the short-term safety of resident-performed intravitreal injections. Methods: We retrospectively reviewed the medical records of 503 patients (503 eyes) treated for the first time in our hospital from January 2018 to October 2020 via intravitreal bevacizumab, ranibizumab, aflibercept, or triamcinolone acetonide injections by residents or retina specialists. In terms of short-term ophthalmic complications, patients were followed-up 1 day, 1 week, and 1 month after injection. Results: A total of 503 eyes of 503 patients were included. Intravitreal injections were given to 211 and 292 eyes by residents (the resident group) and retina specialists (the retina specialist group), respectively. There were no between-group differences in baseline characteristics except in terms of the indications for injection. Intraocular pressure elevation >5 mmHg occurred in two eyes (0.95%) in the resident group and five (1.71%) in the retina specialist group, but the difference was not statistically significant. Subconjunctival hemorrhage occurred in 29 eyes (13.74%) of the resident group and 32 eyes (10.96%) of the retina specialist group; again, the difference was not statistically significant. No case of noninfectious endophthalmitis occurred in the resident group but two (0.68%) cases occurred in the retina specialist group; again, the difference was not significant. There were two (0.95%) cases of infectious endophthalmitis in the resident group and one (0.34%) case in the retina specialist group; again, the difference was not significant. No corneal erosion, traumatic lens damage, vitreous hemorrhage, or retinal tearing or detachment were noted in either group. Conclusions Resident-performed intravitreal injections appear to be safe.

PURPOSE: To analyze the effects of clinical and laboratory factors, including insulin-like growth factor (IGF) levels, on the height velocity of normal prepubertal children. METHODS: Ninety-five healthy prepubertal children (33 boys, 62 girls) were enrolled. The mean chronological age was 6.3±1.4 years, with a height standard deviation score (SDS) of -0.88±0.70. IGF-1, IGF binding protein-3 (IGFBP-3), SDS for anthropometric measurements, and changes in SDS for anthropometric measurements were analyzed for 1 year, and their associations with 1-year height velocity were investigated. RESULTS: The group of children with a 1-year height velocity of ≥6 cm were chronologically younger than the group with a 1-year height velocity of < 6 cm (5.9±1.3 years vs. 6.7±1.3 years, P=0.004), with a lesser increase of SDS for body mass index (BMI) over 1 year (-0.18±0.68 vs. 0.13±0.53, P=0.014). There were no differences between the 2 groups in IGF-1 SDS and IGFBP-3 SDS. Multiple linear regression showed that baseline chronological age (r=0.243, P=0.026) and height SDS (r=0.236, P=0.030) were positively associated with IGF-1 SDS. Binomial logistic regression showed that an older chronologic age at referral (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.47–0.99) and an increase of BMI SDS over 1 year (OR, 0.41; 95% CI, 0.18–0.89) were associated with a decreased growth possibility of an above-average height velocity (≥6 cm/yr). CONCLUSIONS: Height velocity of normal prepubertal children is affected by an increase of BMI SDS and chronological age. Prepubertal IGF-1 SDS reflects height SDS at the time of measurement but is not associated with subsequent height velocity.
Body Mass Index ; Child* ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Linear Models ; Logistic Models ; Referral and Consultation

Solitary plasmacytoma of bone is a rare disease that accounts for only about 3~5% of all plasma cell tumors. Especially, no case of solitary plasmacytoma of a rib origin has been described in the Korean literature. A 54 year old Korean man was referred to our hospital for further evaluation of a lung mass that had been detected on a screening chest radiograph. A tumor with a left 6th rib origin was revealed by the computed tomography (CT) and positive emission tomography (PET-CT); therefore, surgical resection was performed. The histopathological findings of the tumor revealed plasmacytoma of a rib origin. The postoperative screening test revealed no evidence of multiple myeloma. Postoperative radiation therapy was not performed, and no new lesion has been noted during the 2 years of follow up.
Lung ; Mass Screening ; Multiple Myeloma ; Plasmacytoma ; Rare Diseases ; Ribs ; Thorax

PURPOSE: The purpose of this study is to evaluate the clinical and radiological result in patients who got salvage re-fixation for the failed fixation of pertrochanteric fracture retrospectively. MATERIALS AND METHODS: Between 1992 and 2009, 21 patients who could be followed-up for more than 1 year after salvage re-fixation for the failed fixation of pertrochanteric fracture were enrolled in this study. There were 16 men and 5 women. The mean age was 53 years (19-84 years) at the index surgery and the mean follow-up was 6.4 years. We evaluated the clinical and radiographic results and postoperative complications. RESULTS: Walking ability and pain were improved in all cases and the mean leg length discrepancy was improved from 2.5 cm (0-10 cm) preoperatively to 1 cm (0-4 cm) at the latest follow-up. Nineteen patients (90.5%) out of 21 patients achieved bony union at the final evaluation and the mean union time was 4 months (3-7 months). There were 2 cases of non-union who had not received bone graft as a complication. CONCLUSION: The clinical and radiological results of the salvage re-fixation for the failed fixation of pertrchanteric fracture were satisfactory in our study. Secure component fixation for the mechanical stability and proper bone graft for the improvement of bone biology are mandatory to improve the result.
Biology ; Female ; Femur ; Follow-Up Studies ; Humans ; Leg ; Male ; Transplants ; Walking

BACKGROUND: Medication adherence is important for hypertension management but still stay low level. It is reasonable method to classify medication nonadherence into intentional nonadherence and unintentional nonadherence and manage it according to this categories. This study aimed to explore medication adherence and its predictors in community patients with hypertension, especially dividing into intentional nonadherence and unintentional nonadherence. METHODS: Study subjects included 1,988 patients who were prescribed hypertension drugs among 2012 community health survey subjects of 10 cities in Gyeongsangnamdo and we analyzed medication adherence with hypertension and its predictors. We conducted chi-square test for nominal variable and ANOVA test for continuous variable and use multinominal regression to analyze independent predictors of intentional nonadherence and unintentional nonadherence in contrast to medication adherence. RESULTS: Of the 1,988 patients, 49.7% were adherent, 26.1% were unintentionally nonadherent and 24.2% intentionally nonadherent. Independent predictors of unintentional nonadherence were depressive symptoms (odds ratio [OR]=1.696, P=0.047) and arthritis (OR=1.319, P=0.030) and independent predictors of intentional nonadherence were cardiocerebrovascular disease (OR=1.464, P=0.044), self-efficacy (OR=0.984, P=0.007), beliefs about medications questionnaire (necessity [OR=0.834, P<0.001] and concern [OR=1.236, P<0.001]). CONCLUSIONS: In order to manage hypertension in community, improvement in medication adherence is needed. Depressive symptom and self-efficacy need to be managed, but especially patients'beliefs about their medication need to be considered to improve intentional nonadherence.
Aged* ; Arthritis ; Depression ; Gyeongsangnam-do ; Health Surveys ; Humans ; Hypertension* ; Intention ; Medication Adherence*