No abstract available.
Breast Neoplasms* ; Breast*

Atypical cutaneous fibrous histiocytoma (ACFH) is not well known and only a small number of cases have been reported. Characteristically, ACFH is found on the trunk and limbs of middle-aged women. Although considerable cellular atypia may be present, it occurs focally, the remainder of the tumor representing more classical cutaneous fibrous histiocytoma. A 37-year-old woman presented with a solitary brownish firm nodule on her right forearm. No other abnormalities were found in her personal or family history. Clinically, the tumor simulated a benign fibrous histiocytoma. Histologic examination revealed a poorly delineated intradermal tumor with the usual appearance of benign cutaneous fibrous histiocytoma, but a variable pro-portion of cells in the tumor were scattered atypical cells or bizarre multinucleated giant cells. We report upon a rare case of ACFH.
Adult ; Extremities ; Female ; Forearm ; Giant Cells ; Histiocytoma, Benign Fibrous* ; Humans

OBJECTIVE: Fibromyalgia (FM) is a rheumatic disorder characterized by widespread bodily pain, tenderness at multiple sites, and fatigue. It has a major impact on the quality of life. However, there has been no report regarding the health-related quality of life (HRQOL) in Korean patients with FM. The objective of this study was to assess the HRQOL and the correlation among each measurement and to identify the predictors for HRQOL in Korean patients with FM. METHODS: The HRQOL and clinical parameters were assessed by Short Form Health Survey-36 (SF-36), EuroQol 5 Dimensions (EQ-5D), time trade off (TTO), standard gamble (SG), Centers for Epidemiologic StudiesDepression (CES-D), social support, self-efficacy scale, Fibromyalgia Impact Questionnaire (FIQ), and tender points, respectively, from 104 outpatients with FM. RESULTS: Of the 104 subjects, 99 (95.2 %) were women with mean (+/-SD) age of 49.2 years (+/-11.1). The mean (+/-SD) years of disease onset was 8.06 (+/-7.38). The mean (+/-SD) scores of SF-36 global, mental component summary (MCS) and physical component summary (PCS) were 41.6 (+/-19.8), 47.4 (+/-25.0), and 43.5 (+/-23.7), respectively. The SF-36 GH, PCS, MCS scores of FM patients were lower than that of healthy controls (p<0.001). The mean (+/-SD) EQ-5D utility and visual analog scale (VAS) were 0.52 (+/-0.32) and 55.6 (+/-19.4). The mean (+/-SD) scores of the TTO and SG were 0.49 (+/-0.44) and 0.47 (+/-0.42). The mean (+/-SD) scores of CES-D, self-efficacy scale, social support and social network were 16.0 (+/-10.2), 55.9 (+/-19.4), 2.37 (+/-0.27), and 2.07 (+/-0.58), respectively. The mean (+/-SD) scores of FIQ was 46.4 (+/-17.7). The FIQ total score was negatively correlated with the scores of SF-36 GH, MCS, PCS, EQ-5D utility and VAS, TTO, SG, social support, social network, and self-efficacy scale (r=-0.63, r=-0.60, r=-0.48, r=-0.59, r=-0.56, r=-0.32, r=-0.27, r=-0.25, r=-0.31, r=-0.54, respectively. all p's<0.001), and positively correlated with the CES-D (r=0.67, p<0.001). In multivariate models, the predicting variables of SF-36 GH and PCS were age, FIQ, and self-efficacy and the predicting variables of SF-36 MCS were income, FIQ, and social support. CONCLUSION: These results suggest that the HRQOL in Korean patients with FM is lower than healthy subjects. In a simple correlation analysis, FIQ, CES-D, social support, and self-efficacy were meaningful variables correlated with HRQOL. In multivariate model, age, FIQ, and self-efficacy were independent variables correlated with HRQOL. Therefore, the efforts to improve HRQOL in Korean patients with FM should be designed to improve the self-efficacy and depression in addition to conventional approach.
Depression ; Fatigue ; Female ; Fibromyalgia* ; Humans ; Outpatients ; Quality of Life* ; Surveys and Questionnaires ; Visual Analog Scale

Hypochondroplasia is a form of short
Achondroplasia ; Christianity ; Dwarfism ; Extremities ; Hand

Closed intramedullary nailing for trochanteric fractures of femur has many advantages such as minimal operative trauma, low incidence of infection, good stability of fracture, low incidence of delayed or nounion and early ambulation. Complications have been frequently experienced especially in elderly, osteoporotic patients, but these could be avoided by meticulous surgical procedure. The authors hsve treated 99 cases of intertrochanteric fracture and 23 cases of subtrochanteric fracture from March 1982 to December 1987 with this method and the results are summerized as follows : 1. The aversge age was 61.4 yrs. 2. In classification of intertrochanteric fracture, stable fractures(Kyle type I & II) were 53 cases(43.3%) and unstable fractures(Kyle type III & IV) were 46 cases(37.6%). And in subtrochanteric fracture, stable transverse fractures were 12 cases(9.8%) and unstable long oblique or spiral fractures were 11 cases(9.0%). 3. Intraoperative complications were experienced in 23 cases(18.8%). The entry hole breakage was most common and occurred in 16 cases. 4. Of the 94 patients with more than 6 months follow-up, 21 patients(22.3%) showed more than one complication, e.g, knee joint pain in 15 cases, external rotation deformity in 8 and nail migration in 11 including 3 cases of fixation loss and one case of nonunion with nail breakage, etc. 5. Complications occurred more frequently in unstable fractures(31.8%) and in old ages (29.1%) than in stable fractures and in young ages respectively. And it was felt that complications could be minimized by packing of the medullary canal with nails. 6. It is thought that flexible intramedullary nailing is a good method for trochanteric fractures of femur not only in elderly debilitated patients but also in young patients. However, experience and caution are required to prevent complications.
Aged ; Classification ; Congenital Abnormalities ; Early Ambulation ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip Fractures ; Humans ; Incidence ; Intraoperative Complications ; Knee Joint ; Methods

OBJECTIVES: The purpose of this study was to review the current telemedicine of the Korea and the telemedicine of the other countries. METHODS: This study reviewed several documents on telemedicine and summarized the documents on the initiation of the telemedicine of the Korea, the recent regulations of the government, the analytical research results, and the telemedicine of foreign countries. RESULTS: One of recent demonstration trials of telemedicine began in July 2015 in the Korea. The plan was to conduct an emergency telemedical treatment trial among the cooperative medical service centers until the end of February 2016. No telemedical services were provided at the level of local primary care clinics, and there was 1.2% provision at the hospital level. The Europe Union and the United States had more active telemedical services in comparison to the Korea. CONCLUSIONS: The introduction and usage of telemedicine in the Korea was behind those of other countries. It is necessary to develop a proactive support policy for telemedicine through a government implemented trial.
Emergencies ; Europe ; Korea* ; Primary Health Care ; Social Control, Formal ; Telecommunications ; Telemedicine* ; United States

PURPOSE: To evaluate the relationship between RENAL nephrometry score (RNS) and operative approach for renal masses. MATERIALS AND METHODS: This study included 206 consecutive patients who underwent renal tumor surgery between January 2008 and October 2012. We divided the patients into four groups by surgical approach: open radical nephrectomy (ORN, 53 patients), laparoscopic radical nephrectomy (LRN, 83 patients), open partial nephrectomy (OPN, 31 patients), and laparoscopic partial nephrectomy (LPN, 39 patients). We retrospectively assessed the RNS for each surgery group and evaluated the relationship between this score and operative approach. RESULTS: The mean RNSs of the ORN, LRN, OPN, and LPN groups were 9.75, 8.35, 6.72, and 5.76, respectively. When the RNS was analyzed according to nephron-sparing, the mean RNSs of the RN groups (ORN and LRN) and the PN groups (OPN and LPN) were significantly different (8.89 and 6.09, respectively; p<0.001). All the individual components of the RNS were significantly different between RN and PN. In the RN groups, the criteria for open versus laparoscopic surgery were based on tumor size ('R' score=2.43 for open, 1.54 for laparoscopic, p<0.001) and tumor location relative to the polar line ('L' score=2.55 for open, 2.09 for laparoscopic, p=0.006). In the PN groups, the criteria for open or laparoscopic surgery were based only on exophytic/endophytic property ('E' score=1.87 for open, 1.41 for laparoscopic, p=0.046). CONCLUSIONS: The RNS was significantly different in all surgery groups. The decision to take a laparoscopic approach was primarily influenced by the R and L scores for RN and by the E score for PN.
Humans ; Kidney ; Laparoscopy ; Nephrectomy ; Retrospective Studies

Menetrier's disease is a rare disease characterized by the presence of large rugal folds involving part or all of the stomach. Patients with hypertrophic gastropathy often have distressing abdominal symptoms, weight loss and edema due to gastric protein loss. The 48-year-old male patient was admitted to the Hangang Sacred Heart Hospital with cheif complaints of indigestion and epigastric pain. The diagnosis of Menetriers disease is established by radiologic, endoscopic, and pathologic examination. He was treated with soft diet, antacid, H2- receptor antagonist, and IV albumin. We report a case of Menetriers disease with brief review of literatures.
Diagnosis ; Diet ; Dyspepsia ; Edema ; Gastritis, Hypertrophic* ; Heart ; Humans ; Male ; Middle Aged ; Rare Diseases ; Stomach ; Weight Loss

Ischemic myelopahty of spinal cord after cardiac arrest is rarely reported. In general brain stem and spinal cord is less vulnerable to ischemic injury than cerebrum and cerebellum. Ischemic myelopathy usually occurs in the midthoracic region (T3~T8) and rarely reported after cardiac arrest. In this case previously healthy 62 year old patient suffered from cardiac arrhythmia for a few days and then developed cardiac arrest and sustained paraplegia due to ASIA class B spinal cord injury. After paraplegia MRI showed predominant involvement of the anterior horn cell area in the midthoracic region.
Anterior Horn Cells ; Arrhythmias, Cardiac ; Asia ; Brain Stem ; Cardiopulmonary Resuscitation* ; Cerebellum ; Cerebrum ; Heart Arrest ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Paraplegia ; Spinal Cord Injuries ; Spinal Cord Ischemia* ; Spinal Cord*

OBJECTIVE: Athetoid cerebral palsy is a nonprogressive disorder, due to hypoxic injury or jaundice in basal ganglia, characterized by impairment of postural reflexes, arrhythmical involuntary movements, and dysarthria. Dysarthria is a group of motor speech disorder resulting from a disturbance of motor control of the speech mechanism. The purpose of this study is to evaluate the acoustic characteristics of dysarthria in athetoid cerebral palsy. METHOD: We investigated the acoustic characteristics of dysarthria in 8 male patients with athetoid cerebral palsy and 6 males as a control group using Computerized Speech Laboratory (i.e., Multi-Dimensional Voice Program (MDVP), Visi-Pitch, and Electroglottography) and Nasometer. RESULTS: In the MDVP analysis, average fundamental frequency, jitter, and shimmer are significantly increased in patient group as compared to control group (p<0.05). In the Visi-Pitch analysis, maximal phonation and diadochokinetic rate are significantly decreased in patient group (p<0.05). The athetoid cerebral palsied patients have many pitch breaks. Nasalance is not significantly decreased in patient group in comparision with control group. CONCLUSION: We think that average fundamental frequency, jitter and shimmer are increased and maximal phonation time and diadochokinetic rate are decreased in athetoid cerebral palsied patients.
Acoustics* ; Basal Ganglia ; Cerebral Palsy* ; Dysarthria* ; Dyskinesias ; Humans ; Jaundice ; Male ; Phonation ; Reflex ; Voice