No abstract available.
Automatic Data Processing*

Lymphocytic infiltration of the skin(LIS), first described in 1953 by Jessner and Kanot is relatively uncommon disorder, characterized clinicaily by the presence of erythemat.ous peripherally enlarging papules or plaques which may show central clearing. Histologically, the lesions show patch, perivascular and periadnexal lymphocytic infiltrates. We have experienced a case of 30-year old male who had multiple erythematous nodules and plaques on the face and dorsum of the right wrist with 5 years history. He had first noted erythematous plaques on the cheek and these lesions were gradually increasing in size and spreading to the forehead and forearm. He had transiently improved by medication at the drug store, but recurred after discontinuation.
Adult ; Cheek ; Forearm ; Forehead ; Humans ; Male ; Skin* ; Wrist

No abstract available.
Colon*

BACKGROUND AND OBJECTIVES: Recently, internet-based applications of medicine are in the process of rapid development, where concepts of telemedicine and multimedia are important in these application. Hearing test is one of the essential procedures in the otologic field, especially in telediagnosis. A current study for tele-hearing test has some limitations in masking problems or making fully automated system. The aim of this study is to develop a digital air-conduction pure tone audiometer with automated making, which can be used through web-based or off-line to compare the threshold of hearing using conventional and digitalized audiometer in both normal and handicapped hearer. SUBJECTS AND METHOD: To develop an automated audiometer system, we prepared a test scenario data file according to the pure tone test procedure. This scenario was executed in the audiometer main, which is supported by sound card and keyboard (mouse) for output and feedback, respectively, for the examinee. Pure tone for test and white band noise for masking is generated in audiometer sound generation block. To compare this automated audiometer with the conventional one, 25 normal hearers (50 ears) and 25 handicapped hearers (50 ears) were tested. RESULTS: Easy Audiometer 1.0 was developed. The difference of hearing threshold between the two different system was 3-6 dB in the normal hearer group and 2.5-3.5 dB in the handicapped hearer group. Scatter plots showed a close relationship between these two different systems. CONCLUSION: Easy Audiometer 1.0 showed reliable results of hearing threshold in the patient with unilateral hearing who needs masking procedure. Screening and basic hearing tests may be conducted through this Easy Audiometer 1.0 and it could play a part in telediagnosis in the otologic field.
Information Storage and Retrieval ; Disabled Persons ; Hearing ; Hearing Tests ; Humans ; Masks* ; Mass Screening ; Multimedia ; Noise ; Telemedicine

OBJECTIVE: This study is intended to identify predictive factors of delirium, including risk factors and prodromal symptoms. METHODS: This study included sixty-five patients aged 65 years or older who had undergone hip surgery. Baseline assessments included age; gender; admission type (acute/elective); reason for surgery (fracture/replacement); C-reactive protein (CRP); Acute Physiology, Age, Chronic Health Evaluation (APACHE III); and the Mini-Mental State Examination (MMSE). The Korean version of the Delirium Rating Scale-Revised-98 (K-DRS-98) was used to assess prodromal symptoms daily before the onset of delirium. RESULTS: Almost 28% (n=18) of the 65 patients developed delirium after surgery. Delirium in elderly patients after hip surgery was observed more often in older patients and those with acute admission, hip fracture, higher APACHE III score, lower MMSE score, and higher CRP levels within early days after the operation. Sleep-wake cycle disturbances, thought process abnormalities, orientation, and long-term memory in symptom items of K-DRS-98 were showed significant difference on 4 days before delirium, lability of affect on 3 days before, perceptual disturbances and hallucination, and visuo-spatial ability on 2 days before, and delusion, motor agitation, and short-term memory on the day before the occurrence of delirium. CRP levels within 24 hours and 72 hours after hospitalization were significantly higher in the delirium group. CONCLUSION: Medical professionals must pay attention to behavioral, cognitive changes and risk factors in elderly patients undergoing hip surgery and to the prodromal phase of delirium. K-DRS-98 may help in identifying the prodromal symptoms of delirium in elderly patients after hip surgery.
Aged ; APACHE ; C-Reactive Protein ; Delirium ; Delusions ; Dihydroergotamine ; Hallucinations ; Hip ; Hospitalization ; Humans ; Memory, Long-Term ; Memory, Short-Term ; Orientation ; Prodromal Symptoms ; Risk Factors

No abstract available.
Aged, 80 and over ; Cholecystitis/*complications/diagnosis ; Hemobilia/diagnosis/*etiology ; Humans ; Jaundice, Obstructive/etiology ; Male

OBJECTIVE: This study was conducted to investigate anger in elderly patients with depressive disorders. METHODS: The subjects included 216 elderly patients with depression and 198 controls. All subjects were assessed by the State and Trait Anger Inventory (STAXI), Aggression Questionnaire (AQ), Reaction Inventory (RI). RESULTS: Elderly patients with depressive disorder showed lower levels of trait anger and anger expression on the STAXI, lower levels of verbal aggression and hostility on the AQ, and lower levels of anger reaction to the unpredictable disruption and disturbances factor, the embarrassing circumstances factor, and the personal disrespect factor on the RI than the controls. In the depression group, the severity of their depression was positively correlated with the trait anger, state anger, anger expression (except 'anger control') scores on the STAXI; the physical aggression, anger, and hostility scores on the AQ; and the anger reaction to unpredictable disruption and disturbances factor, the embarrassing circumstances factor, and the personal disrespect factor scores on the RI. However, the severity of depression negatively correlated with only anger control on the STAXI. In the linear logistic regression analysis, as there were higher levels of state anger seen in the STAXI, anger on the AQ, anger reaction to unpleasant factors on the RI, and therefore the likelihood of depression would be higher. CONCLUSION: Elderly depressive patients are less likely to have anger traits and to express anger than normal elderly. However, in elderly depressive patients, the higher they have severity of depressive symptoms, the higher they reported anger experience and anger expression.
Aged ; Aggression ; Anger ; Depression ; Depressive Disorder ; Hostility ; Humans ; Logistic Models ; Surveys and Questionnaires

PURPOSE: To analyze the causes and the clinical results of treatment for the nonunion of femur shaft fractures that occurred after interlocking intramedullary nail fixation. MATERIALS AND METHODS: We reviewed 19 cases of aseptic nonunion of femur shaft fracture in 174 patients after interlocking IM nailing from March 1999 to February 2004 and followed up for more than one year. First we investigated the factors causing nonunion. For operative options, two methods about exchange nailing and exchange nailing with bone graft were performed. Finally clinical results were analyzed with bone union rate by treatment methods and compared with the nonunion factors statistically. RESULTS: According to the causes and types of nonunion, we performed larger IM nail change in 10 cases and IM nail change with bone graft in 9 cases. Bone union was achieved in all cases. Average bone union period were 18.5 weeks in exchange group and 16.1 weeks in exchange with bone graft group. There are significant difference between treatment methods statistically (p<0.05). Compared with the nonunion factors, initial open fracture and smoking groups showed late union rate statistically. CONCLUSION: Based on our analysis, IM nail change is a useful method for nonunion after initial IM nailing in femoral shaft fracture, and additional bone graft that according to the radiologic pattern and stability, especially the fracture gap is also a useful option for nonunion treatment.
Femur ; Fracture Fixation, Intramedullary* ; Fractures, Open ; Humans ; Methods ; Smoke ; Smoking ; Transplants

PURPOSE: To document the incidence and analyze the causes of anterior knee pain following closed intramedullary nailing for tibial fractures. MATERIALS AND METHODS: Between January 2005 and February 2007, 50 tibial fractures (48 patients) were treated using locked intramedullary nails. We examined the relationship between postoperative anterior knee pain and age, gender distribution, mechanism of injury, cause and type of fracture, method of patellar tendon incision, and position of the nails on radiography. Anterior knee pain was assessed using a visual analogue scale (VAS). Pearson chi-square test was used to assess the incidence of knee pain. RESULTS: At a mean follow-up period of 16 months (range 13-30 months), 23 cases (46%) had developed anterior knee pain. Knee pain was more common in woman (p=0.000), but there was no statistically significant difference with regard to age, cause or type of fracture, reaming or incision technique. If the knee apex distance was below -30 mm on radiological analysis, there was no statistically significant increase in postoperative knee pain (p=0.000). Nail removal resolved or improved the symptoms in 77% of patients with anterior knee pain. CONCLUSION: Based on these data, nail prominence correlated with increased knee pain. We believe surgeons can decrease the severity of knee pain after tibial nailing by burying the tip of the nail as reflected on lateral radiographs.
Female ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Incidence ; Knee ; Nails ; Patellar Ligament ; Tibial Fractures

PURPOSE: To analyze the factors affecting the nonunion of extraarticular proximal tibial fracture and the outcome of nonunion treatment. MATERIALS AND METHODS: We investigated 51 cases of extraarticular proximal tibial fractures from June 2002 to May 2006. The nonunion rate was assessed in relation to several risk factors and the treatment outcome of nonunion using plate fixation with bone graft was assessed by Klemm and BOrner functional rating system. RESULTS: 6 cases of nonunion (11.8%) was noted among 51 cases, and the risk factors examined, OTA A3 comminuted fracture was associated with a high nonunion rate with statistical significance and initial bone graft had a significant effect in bone healing. Excellent and good results were obtained in 5 cases (83.3%) and bone union was achieved in all nonunion cases. CONCLUSION: Comminution was found to be an important factor affecting the nonunion in extraarticular proximal tibial fracture, and bone graft in primary operation could reduce the chance of nonunion. Accurate plate fixation with bone graft is a reliable option in nonunion treatment.
Fractures, Comminuted ; Risk Factors ; Tibial Fractures ; Transplants ; Treatment Outcome