The carpal injury is difficult to diagnose due to anatomical complexity and the like. So, in order to get radiological knowledge of normal wrist, the authors measured the values which will be described on the wrist PA and lateral roengenogram obtained from 440 normal wrists(male : 188 cases, female : 252 cases) in randomly selected patients. The following results were obtained. l. Ulnar variance(mm±standard deviation): Total 1.1±1.2 : negative variance : 9.3%, positive variance : 56.1%, 2. Scapholunate Gap(mm±standard deviation): Total 0.4±0.7, 3. Ulnar Tilt(degrees±standard deviation): Total 23.6±5.3, 4. Volar Tilt, 5. Carpal height rstio : Total 0.52±0.05 male 0.53±0.04 female 0.51±0.05 : Total 13.1±5.9, 6. Carpal ulnsr distance ratio Total 0.05±0.05, 7. Scapholunate Angle : Total 49.9'±10.1', 8. Capitatolunate Angle Total 17.5'±10.0', 9. Radiolunate Angle Total 8.8'±6.7', 10. Carpal width ratio Total 0.72±0.08 11. Carpal thickness ratio Total 0.49±0.07.
Female ; Humans ; Male ; Wrist

OBJECTIVE: Whether exposure to chronic noise induces an increase in blood pressure, or the development of hypertension, has not been established. A cohort study was performed to identify the effects of chronic noise exposure on blood pressure. METHODS: 530 males working at a metal manufacturing factory in Busan, Korea were enrolled for the study. They were monitored for 9 consecutive years, from 1991 to 1999, with an annual health check-up. The subjects were divided into 4 groups, which were determines by noise level categories(NLC) according to noise intensity ; NLC-I: office workers, exposed to noise a level below 60dB(A); NLC-II: field technical supporters or supervisors, frequently exposed to workplace noise, wearing no hearing protection device; NLC-III: workers, exposed to workplace noise below 85 dB(A), wearing ear plugs or muffs; NLC-IV: workers, exposed to workplace noise over 85 dB(A), wearing both ear plugs and muffs. RESULTS: After controlling possible confoundens, such as baseline age, smoking, alcohol intake, exercise, family history of hypertension, systolic(SBP) or diastolic blood pressure(DBP) and changes in BMI (body mass index), the pooled mean for the systolic blood pressures, over the duration of the study period, were 3.8mmHg, 2.0mmHg and 1.7mmHg higher in NLC-IV, NLC-III NLC-II groups, respectively, than in the NLC-I group. There were no significant differences in the diastolic blood pressures between the groups. CONCLUSION: This study suggests that chronic noise exposure increases systolic blood pressure independently, among male workers.
Blood Pressure* ; Busan ; Cohort Studies* ; Ear ; Hearing ; Humans ; Hypertension ; Korea ; Male* ; Noise* ; Smoke ; Smoking

Chronic rhinosinusitis (CRS) is further classified as CRS with nasal polyp and CRS without nasal polyp. It is also divided into type 2 and none-type 2 by immunological endotype. Nowadays, novel biological products targeting type 2 inflammation are developed and used for the treatment of CRS with nasal polyp.Current Concepts: Dupilumab, which inhibits interleukin-4 and interleukin-13, and omalizumab, which targets immunoglobulin E, were recently approved and are currently being used as the treatment regimen for patients with recurrent CRS with nasal polyp in Korea. Many studies demonstrated enough effects of both biological products on nasal symptoms, including smell, quality of life, and polyp size. The indication of biological products is refractory CRS with nasal polyp with severe symptoms even after endoscopic sinus surgery. However, the main drawback of these biological products is a high cost since they are non-reimbursement regimens as defined by Korean national health insurance.Discussion and Conclusion: Further research on the use of dupilumab and omalizumab in Korean patients will be needed because the Korean CRS endotype, which is characterized by less-type-2 CRS, is different from Western CRS endotypes. Additionally, investigations on the comparison of efficacy among various biological products are essential to prescribe the most appropriate biological products depending on the patients’ endotypes.

BACKGROUND: Infarct size determines left ventricular (LV) systolic and diastolic dysfunctions after acute myocardial infarction, and also may affect the recovery from functional impairment. We studied the differences of LV remodeling and changes of systolic and diastolic functions of LV during two weeks after acute myocardial infarction, according to Killip class at admission. METHODS: Echocardiographic examinations were performed within two days (23.9+/-2.3 hours), and two weeks after the attack in 27 patients with acute myocardial infarction, and the results were compared with those of 19 controls. Patients were divided into two groups according to Killip class at admission; 18 patients in Killip class I (group I) and 9 patients in Killip class II to IV (group II). Group II had larger infarct, reflected by higher levels of peak serum cardiac enzymes. RESULTS: LV systolic function was more depressed in group II. Regional wall motion score index decreased in group I after two weeks, but not in group II. LV systolic and diastolic volume indexes increased after two weeks in group II but not group I. E/A ratio of mitral inflow was less than 1, and isovolumic relaxation time was prolonged in group I immediately after the attack. Group II had E/A>1 and shorter deceleration time (DT) of mitral inflow, and higher peak reverse flow velocity associated with atrial contraction (AR) of pulmonary venous flow than those of controls immediately after the attack. In group II, E/A ratio was greater, DT was shorter, peak systolic/diastolic flow velocity ratio of pulmonary venous flow was less, and AR was higher than those of controls after two weeks. CONCLUSION: Infarct size affected remodeling and changes of systolic and diastolic functions of LV after acute myocardial infarction. In patients with large infarct, LV was dilated and regional wall motion was not improved during two weeks. Restrictive pattern of LV filling, which was more aggravated during two weeks, was noted immediately after the attack. In patients with small infarct, LV was not dilated and regional wall motion was improved during two weeks. LV filling pattern showed relaxation abnormality.
Deceleration ; Echocardiography ; Heart Ventricles* ; Humans ; Myocardial Infarction* ; Relaxation

Fibrous dysplasia (FD) is a non-malignant progressive condition, which replaces normal bone and marrow with fibrous tissue and woven bone. Sinus mucocele is a cystic, expansile, and destructive lesion that occurs as a result of obstruction of the sinus ostium secondary to inflammation, trauma, anatomical variation, previous sinus surgery, tumor or FD. Among them, FD combined with mucocele has been rarely reported. Here we report the first case of FD combined with ethmoid mucocele. The patient underwent endoscopic debulking of FD and marsupialization of mucocele. The mucocele was successfully marsupialized, and the patient’s symptoms were completely resolved. We propose a new hypothesis that nasal mucosa invaginates into FD and forms a mucocele. For the treatment of ethmoid FD combined with mucocele, we recommend an endoscopic transnasal approach for debulking and marsupialization.

PURPOSE: To assess the differences in bone mineral density (BMD) of lumbar spine and wrist between preterm infants of postconceptional age 40 weeks and normal full-term infants. MATERIALS AND METHODS: Sixty-eight preterm infants born at conceptional age 26 -36 weeks and 31 normal full-term infants born at 38 -42 weeks were investigated. Bone mineral densities of the lumbar spine (from the second to the fourth segment) and wrist were measured by dual energy X-ray absorptiometry. In preterm infants, the corrected age of 0 month was defined as postconceptional 40 weeks. Full-term infants were evaluated within three days of birth, and the average bone mineral densities of preterm and full-term infants were compared. In the preterm group, birth weight and conceptional age were correlated with lumbar spinal and wrist bone mineral densities. Data were analyzed by student's t-test and Pearson's correlation coefficient, and a pvalue of less than 0.05 was considered significant. RESULTS: In preterm in fants, the values of bone mineral densities of the lumbar spine and wrist were 0.137 +/- 0.018 g/cm2(0.061 -0.202 g/cm2) and 0.089 +/-0.013 g/cm2 (0.065 -0.123 g/cm2), respectively, while the respective values for full-term infants were 0.214 +/-0.030 g/cm2 (0.160 -0.296 g/cm2) and 0.118 +/-0.014 g/cm2(0.096 -0.162 g/cm 2). In the preterm group, lumbar spinal BMD correlated significantly with conceptional age(r=0.384, p<0.05) and birth weight (r=0.438, p<0.05). While wrist BMD correlated significantly with birth weight (r=0.281, p<0.05), its correlation with conceptional age was not significant (r=0.223, p>0.05). CONCLUSION: The lumbar spinal and wrist BMDs of preterm infants at corrected age 0 were lower than those of normal full-term infants. In the preterm group, BMD values for the lumbar spine were lower in infants of lower conceptional age and birth weight.
Absorptiometry, Photon* ; Birth Weight ; Bone Density* ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Parturition ; Spine* ; Wrist*

A 33-year old male was admitted due to continuous high spiking fever for 2 months via local clinic. He had been diagnosed pulmonary tuberculosis at local clinic. However, spiking fever had not been controlled by anti-tuberculous medications. Chest PA showed confluent consolidation on right upper & mid-lung field. 5 anti-tuberculous regimens (Streptomycin, Isoniazid, Rifampin, Ethambutol, Pyrazinamaide) were administered initially and steroid therapy was followed for relieving toxic symptoms Very slowly resolved chest X-ray lesion and continuous fever suggested the possibility of misdiagnosis. After 60th hospital day, the chest X-ray lesion was resolved gradually and fever subsided almost completely. He was discharged on 76th hospital day with anti-tuberculous drugs and steroid(prednisolon), without any other problems except sustained mild fever.
Diagnostic Errors ; Ethambutol ; Fever* ; Humans ; Isoniazid ; Male ; Pneumonia* ; Rifampin ; Thorax ; Tuberculosis, Pulmonary

No abstract available.

BACKGROUND: The rate of rise of left ventricular(LV) systolic pressure, dp/kt, and the peak ejection rate(PER) of LV may be more accurate indices for assessing LV systolic function than ejection fraction(EF). Both can be easily obtained by noninvasive methods, M-mode echo/phonocardiography and automated border detection(ABD) echocardiography, respectively. Mean dp/dt by M-mode echo/phonocardiography and PER by ABD echocardiography were compared with mean dp/dt by Doppler echocardiography. METHODS: Twenty-one adult patients who had normal sinus rhythm, mitral regurgitant signals by continuous wave Doppler echocardiography and an apical 4 chamber view of LV in which at least 75% of the endocardium was clearly visualized were selected for our study. The off-line estimation of LV end-diastolic volume (1) were performed by the method of disc, after manually tracing the endocardial border on the apical 4 chamber view and EF was calculated. M-mode echocardiography of the aortive valve and phonocardiography were simultaneously recorded on the strip chart to measure the isovolumic contraction time(dtM). A blood pressure (2) and LV end-diasolic pressure(LVEDP) was assigned 20mmHg in patients with Q wave myocardial infarction or EF< or =40% and 10mmHg in others. The mean dp/dtM during isovolumic contraction time was calculated as (aortic diastolic pressure-LVEDP)/dtM and was compared with the Doppler-derived mean rate of LV pressure rise(dp/dtDoppler) over the time period between velocities of 1 and 3m/sec on the ascending slope of the Doppler velocity spectrum. ABD system was used to measure the changes in LV volume and PER on the apical four chamber view. PER was compared with mean dp/dtDoppler. RESULTS: Mean dp/dtM positively correlated with mean dp/dtDoppler(r=0.73, p<0.001), but the limits of agreement between two methods were somewhat wide(-659-937mmHg/sec). PER also positively correlated with dp/dtDoppler and EF(r=0.73, p<0.001 ; r=0.80, p<0.001). CONCLUSIONS: Mean dp/dtM by M-mode echo/phomocardiography and PER by ABD echocardiography may be useful indices for assessing LV systolic function.
Adult ; Blood Pressure ; Echocardiography* ; Echocardiography, Doppler ; Endocardium ; Humans ; Myocardial Infarction ; Phonocardiography

A 48-year-old woman with cystic fibrosis and a previous left pneumonectomy had surgery planned for single lung transplantation under general anesthesia. Due to progressive dyspnea and recurrent respiratory infection, she could not maintain her normal daily life without lung transplantation. The anesthetic management and surgical procedure was expected to be difficult because of the left mediastinal shift and an asymmetric thorax after the left pneumonectomy, but the single lung transplantation was successfully done under cardiopulmonary bypass.
Anesthesia, General ; Cardiopulmonary Bypass ; Cystic Fibrosis ; Dyspnea ; Female ; Humans ; Lung ; Lung Transplantation ; Middle Aged ; Pneumonectomy ; Thorax