PURPOSE: Fractures of trapezium are uncommon carpal bone fractures and often unrecognized lesions. We investigated about operative treatment of trapezium fracture. MATERIALS AND METHODS: Seven patients with fractures of trapezium were evaluated after surgical treatment with a mean follow up time of 18 months (12 months~3 years). Functional assessment (pain, limitation in activities of daily living, satisfaction), physical examination (range of motion, grip strength), and radiographic evaluation were performed. Traumatic arthritis and carpometacarpal joint subluxation were confirmed by radiograph. RESULTS: During study period, 122 cases were carpal bone fractures, and seven of 122 cases were fractures of trapezium. All cases were intra-articular fractures of trapezium. 1st carpometacarpal joint dislocation at 4 patients, Bennett's fracture at 1 patient, hamate hook fracture at 1 patient, and base of 4th proximal phalanx fracture at 1 patient were associated with fracture of trapezium. Open reduction and internal fixation were performed at 6 cases and 1st carpometacarpal joint arthrodesis was performed at 1 case because of neglected fracture. One of 6 cases which were performed to open reduction and internal fixation was reoperated to external fixation due to reduction loss. Clinically 6 patients revealed good results. one of 7 patients experienced limitation of thumb opposition. CONCLUSION: Based on the good results obtained with surgical intervention, we advocated open reduction and internal fixation for fractures with intraarticular depressed more than 2 mm or combined with Bennett's fracture or carpometacarpal subluxation.
Activities of Daily Living ; Arthritis ; Arthrodesis ; Carpal Bones ; Carpometacarpal Joints ; Dislocations ; Follow-Up Studies ; Hand Strength ; Humans ; Intra-Articular Fractures ; Physical Examination ; Thumb

STUDY DESIGN: Retrospective study. PURPOSE: First, to examine the association between bone mineral density (BMD) and the halo phenomenon, and second, to investigate risk factors predisposing to the halo phenomenon and its correlation with clinical outcomes. OVERVIEW OF LITERATURE: The few in vivo studies regarding the relationship between pedicle screw stability and BMD have shown conflicting results. METHODS: Forty-four female patients who underwent spine fusion surgery due to spinal stenosis were included in this study. The halo phenomenon and fusion state were evaluated through plain radiographs performed immediately after surgery and through the final outpatient follow-up examination. BMD, osteoarthritis grade in the hip and knee joints, and surgical outcome were also evaluated. RESULTS: BMD was not related to the halo phenomenon, but age, absence of osteoarthritis in the knee, and non-union state were found to be significant risk factors for the halo phenomenon. However, the radiological halo phenomenon did not correlate with clinical outcome (visual analogue scale for back pain and leg pain). CONCLUSIONS: The halo phenomenon is a simple phenomenon that can develop during follow-up after pedicle screw fixation. It does not influence clinical outcomes, and thus it is thought that hydroxyapatite coating screws, expandable screws, cement augmentation, and additional surgeries are not required, if their purpose is to prevent the halo phenomenon.
Back Pain ; Bone Density ; Durapatite ; Female ; Follow-Up Studies ; Hip ; Humans ; Knee ; Knee Joint ; Leg ; Osteoarthritis ; Outpatients ; Retrospective Studies ; Risk Factors ; Spinal Stenosis ; Spine

BACKGROUND: Hypercholesterolemia is a risk factor of cardiovascular diseases and metabolic syndrome. Cholesterol level in childhood is related to the development of cardiovascular diseases in adulthood. This study aimed to investigate cholesterol levels of first grade students in elementary school, to analyze the relationship between the children's cholesterol levels and those of parents' and to evaluate the factors influencing children's cholesterol levels. METHODS: In 2004, a sample of 108 first-graders in elementary school in Gwacheon city and their 216 parents were included in this study. Height, weight, body mass index, waist and hip circumference and blood pressure were measured and bio-chemical data were obtained. The children's birth weight, eating habits, physical activity, occupation, educational background, married status, mean monthly income of each family were obtained by questionnaire. RESULTS: The correlation coefficient between children's cholesterol and fathers' cholesterol was 0.331 (P<0.001). The correlation coefficient between children's cholesterol and mothers' cholesterol was 0.364 (P<0.001). The mean total cholesterol level in children differed significantly according to mother's smoking status, mother's overeating due to stress and mother's diet restriction tendency for weight control. In multiple linear regression analysis of children's cholesterol as dependent variable, the explanation power (R(2)) of the model including children's sex, father's age and cholesterol levels, mother's age and cholesterol levels was 0.281. The explanation power (R(2)) of the other model including variables of the previous model and children's fruit consumption, parent's eating out tendency, mother's smoking status, mother's other behavior during mealtime, mother's overeating due to stress and mother's diet restriction tendency for weight control was 0.388. In final model, only the parent's cholesterol levels had significant effect on children's cholesterol levels. CONCLUSION: It was parent's cholesterol level that affected significantly on the children's cholesterol level.
Birth Weight ; Blood Pressure ; Body Weight ; Cardiovascular Diseases ; Child* ; Cholesterol* ; Diet ; Eating ; Fruit ; Gyeonggi-do* ; Hip ; Humans ; Hypercholesterolemia ; Hyperphagia ; Linear Models ; Meals ; Motor Activity ; Occupations ; Parents* ; Risk Factors ; Smoke ; Smoking ; Surveys and Questionnaires

Primary malignant melanoma (PMM) of the gastrointestinal tract is rare. Reported cases of PMM of the lower gastrointestinal tract typically describe anal and rectal involvement rather than colonic lesions. This report describes a rare case of a 50-year-old woman with PMM originating in the colon. The patient presented to Inje University Busan Paik Hospital with a 3-day history of blood-tinged stools. She underwent colonoscopy for a diagnosis of hematochezia. The colonoscopic examination revealed a large-sized semi-pedunculated sigmoid colon polyp with a reddish-colored mucosal surface. Endoscopic mucosal resection was performed, and the final histopathological findings were consistent with a diagnosis of malignant melanoma. Systemic work-up was performed for assessment of metastasis and to identify the primary tumor considering the high metastatic rate of gastrointestinal malignant melanoma; however, no other malignant lesion was detected. Thus, she was diagnosed with colonic PMM. She underwent laparoscopic low anterior resection and lymph node dissection and has been recurrence-free for > 2 years.
Busan ; Colon ; Colon, Sigmoid ; Colonoscopy ; Diagnosis ; Female ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Humans ; Lower Gastrointestinal Tract ; Lymph Node Excision ; Melanoma ; Melanosis ; Middle Aged ; Neoplasm Metastasis ; Polyps

Objective: : Bevacizumab is a feasible option for treating cerebral radiation necrosis (RN). We investigated the clinical outcome of RN after treatment with bevacizumab and factors related to the initial response and the sustained effect. Methods: : Clinical data of 45 patients treated for symptomatic RN between September 2019 and February 2021 were retrospectively collected. Bevacizumab (7.5 mg/kg) was administered at 3-week intervals with a maximum four-cycle schedule. Changes in the lesions magnetic resonance image (MRI) scans were examined for the response evaluation. The subgroup analysis was performed based on the initial response and the long-term maintenance of the effect. Results: : Of the 45 patients, 36 patients (80.0%) showed an initial response, and eight patients (17.8%) showed delayed worsening of the corresponding lesion. The non-responders showed a significantly higher incidence of diffusion restriction on MRI than the responders (100.0% vs. 25.0%, p<0.001). The delayed worsening group showed a significantly higher proportion of glioma pathology than the maintenance group (87.5% vs. 28.6%, p=0.005). Cumulative survival rates with sustained effect were significantly higher in the groups with non-glioma pathology (p=0.019) and the absence of diffusion restriction (p<0.001). Pathology of glioma and diffusion restriction in MRI were the independent risk factors for non-response or delayed worsening after initial response. Conclusion : The initial response of RN to bevacizumab was favorable, with improvement in four-fifths of the patients. However, a certain proportion of patients showed non-responsiveness or delayed exacerbations. Bevacizumab may be more effective in treating RN in patients with non-glioma pathology and without diffusion restriction in the MRI.

BACKGROUND/AIMS: There is an increased risk of tuberculosis (TB) with impaired cellular immunity and extrapulmonary TB is more common in patients with chronic kidney disease. We explored the clinical features and treatment outcomes of extrapulmonary TB according to renal function. METHODS: This retrospective study reviewed the medical records of patients diagnosed with extrapulmonary TB between January 2003 and December 2007. We classified the patients into two groups using the glomerular filtration rate (eGFR), estimated using the Modification of Diet in Renal Disease (MDRD) formula cut-off of 60 mL/min/1.73 m2 and evaluated their clinical features, treatment outcome and mortality (Group I vs. Group II, > or = 60 mL/min/1.73 m2). RESULTS: The mean eGFR of Groups I (n=30) and II (n=312) was 34+/-19 and 102+/-26 mL/min/1.73 m2, respectively. The pleura was the most frequent site of TB in both groups (Group I, 30.0% vs. Group II, 28.2%; p=0.379). There was no treatment failure or recurrence in either group. The mortality was higher in Group I (22.2% vs. 2.8%; p<0.01). In a multivariate analysis, eGFR<60 mL/min/1.73 m2 was an independent risk factor for mortality (HR=11.51, CI 2.512-52.741; p=0.002). CONCLUSIONS: Mortality related to extrapulmonary TB was higher in patients with impaired kidney function and kidney function was an independent predictor. However, there was no difference in treatment failure and recurrence according to renal function.
Diet ; Glomerular Filtration Rate ; Humans ; Immunity, Cellular ; Kidney ; Medical Records ; Multivariate Analysis ; Pleura ; Prognosis ; Recurrence ; Renal Insufficiency, Chronic ; Retrospective Studies ; Risk Factors ; Treatment Failure ; Treatment Outcome ; Tuberculosis

No abstract available.

No abstract available.

BACKGOUND: The late referral to nephrologist was founded as independent risk factor of poor survival in hemodialysis patients. Patients referred lately are prone to initiate dialysis urgently through temporary catheter and the use of catheter increase the incidence of catheter related complications. But patients' survival may be influenced by multiple and more complex factors beside referral pattern and use of catheter. So we planed to evaluate the effect of referral pattern on patients' survival and related factors. METHODS: This analysis included 629 incident hemodialysis patients in single center. Demographical, clinical, laboratory data were collected retrospectively. Early referral was defined as first nephrology visit over 3 months prior to initiation of dialysis. Clinical characteristics were compared between early (ER) and late referral groups (LR). Survival analysis and Cox models were performed to assess the relationship of referral pattern and mortality. Significant differences were defined as p value less than 0.05. RESULTS: ER included 269 patients and their mean age, male proportion were not different from those of LR. In ER, pre-dialysis education program and nutritional counseling were offered much more than LR and lesser catheter usage, higher serum albumin at the initiation of dialysis. ER survived longer but in Cox models, only older age, presence of diabetes, lower serum albumin at the initiation of dialysis were independent risk factor for death (odds ratio 1.047, 1.547, 0.615, respectively) CONCLUSION: Although early referral decrease catheter use at the initiation and urgent hemodialysis, classical risk factors such as old age, presence of diabetes, nutritional status at the initiation are more important in patients prognosis.
Catheters ; Counseling ; Dialysis ; Education ; Humans ; Incidence ; Male ; Mortality ; Nephrology* ; Nutritional Status ; Prognosis ; Proportional Hazards Models ; Referral and Consultation* ; Renal Dialysis* ; Retrospective Studies ; Risk Factors ; Serum Albumin

PURPOSE: The purpose of this study was to investigate the feasibility and survival benefits of combined treatment with radiotherapy and adjuvant temozolomide (TMZ) in a Korean sample. MATERIALS AND METHODS: A total of 750 Korean patients with histologically confirmed glioblastoma multiforme, who received concurrent chemoradiotherapy with TMZ (CCRT) and adjuvant TMZ from January 2006 until June 2011, were analyzed retrospectively. RESULTS: After the first operation, a gross total resection (GTR), subtotal resection (STR), partial resection (PR), biopsy alone were achieved in 388 (51.7%), 159 (21.2%), 96 (12.8%), and 107 (14.3%) patients, respectively. The methylation status of O6-methylguanine-DNA methyltransferase (MGMT) was reviewed retrospectively in 217 patients. The median follow-up period was 16.3 months and the median overall survival (OS) was 17.5 months. The actuarial survival rates at the 1-, 3-, and 5-year OS were 72.1%, 21.0%, and 9.0%, respectively. The median progression-free survival (PFS) was 10.1 months, and the actuarial PFS at 1-, 3-, and 5-year PFS were 42.2%, 13.0%, and 7.8%, respectively. The patients who received GTR showed a significantly longer OS and PFS than those who received STR, PR, or biopsy alone, regardless of the methylation status of the MGMT promoter. Patients with a methylated MGMT promoter also showed a significantly longer OS and PFS than those with an unmethylated MGMT promoter. Patients who received more than six cycles of adjuvant TMZ had a longer OS and PFS than those who received six or fewer cycles. Hematologic toxicity of grade 3 or 4 was observed in 8.4% of patients during the CCRT period and in 10.2% during the adjuvant TMZ period. CONCLUSION: Patients treated with CCRT followed by adjuvant TMZ had more favorable survival rates and tolerable toxicity than those who did not undergo this treatment.
Biopsy ; Chemoradiotherapy* ; Disease-Free Survival ; Follow-Up Studies ; Glioblastoma* ; Humans ; Korea* ; Methylation ; Radiotherapy ; Retrospective Studies* ; Survival Rate