A total of 16 metatarsal bones were treated for ten with brachymetatarsia using two different methods: single staged lengthening by bone graft(2 cases) and gradual distraction lengthening using unilateral external fixator(14 cases). Three cases of first metatasal bone and thirteen cases of fourth metatarsal bone were operated. All of the cases of the brachymetatarsia were congenital. The average amount of lengthening was 16.1 mm in gradual distraction lengthening while 10.5mm in single staged lengthening. Average percentile increase was 38.8% in gradual distraction lengthening and 23% in single staged lengthening. The average healing index of gradual distraction lengthening was 1.7(months/cm). Although single staged lengthening has advantage of cosmetics, gradual distraction lengthening using unilateral external fixator was thought to be effective functionally for metatarsal lengthening.
External Fixators ; Metatarsal Bones

OBJECTS: Synovial thickness in carpal tunnel was measured by high-resolution ultrasonography to evaluate the relation of synovial hypertrophy in idiopathic carpal tunnel syndrome. MATERIALS AND METHODS: Thickness of synovium of flexor tendons in 46 hands of idiopathic carpal tunnel syndrome and 50 hands of normal control were measured quantitatively by high-resolution ultrasonography. The patients were classified into three groups according to the clinical severity: Group I had typical clinical symptoms and positive provocation test (17 cases) , Group II had sensory decreation on the dermatome of median nerve (21 cases) , and Group III had sensory decreation and thenar muscle weakness. The thickness of flexor tendons in the three groups and control group were statistically compared. RESULTS: The mean value of thickness of carpal tunnel syndrome was 1.06mm and that of control group was 0.87mm (p=0.012) . Positive correlation was revealed according to the clinically classified three groups. CONCLUSION: Synovial hypertrophy in carpal tunnel has positive relationships with idiopathic carpal tunnel syndrome, and it reveal possibly the progression of the disease.
Carpal Tunnel Syndrome* ; Hand ; Humans ; Hypertrophy* ; Median Nerve ; Muscle Weakness ; Synovial Membrane ; Tendons ; Ultrasonography

We report a case involving the development of a delayed acute subdural hematoma (ASDH) after trauma, with the absence of any abnormal radiological and clinical findings at initial examination. A 54-year-old male visited the emergency department after a minor trauma. The patient only complained of mild headache after head injury. He presented no abnormal findings on neurological examination, and brain computed tomography (CT) did not show any intracranial lesion or skull fractures. However, he developed seizure with disorientation eight hours after trauma, and ASDH with midline shift was found during a follow-up CT. He recovered without neurological deficits after immediate primary care and admission to the neurosurgery department. On serial follow-up CT images, a gradually increasing mass effect of hematoma was detected, and removed by craniotomy. The patient recovered without neurologic deficits.
Brain ; Brain Injuries* ; Craniocerebral Trauma ; Craniotomy ; Decompression, Surgical ; Emergency Service, Hospital ; Follow-Up Studies ; Headache ; Hematoma ; Hematoma, Subdural, Acute* ; Humans ; Male ; Middle Aged ; Neurologic Examination ; Neurologic Manifestations ; Neurosurgery ; Primary Health Care ; Seizures ; Skull Fractures

BACKGROUND/AIMS: Chronic hepatitis B infection is a common cause of secondary membranous nephropathy (MN) in endemic areas. Lamivudine treatment improves renal outcome in patients with hepatitis B virus-associated MN (HBV-MN), but prolonged use leads to the emergence of lamivudine-resistant variants. We describe our experience treating lamivudine-resistant and other strains of HBV-MN with new antiviral drugs. METHODS: Of the 89 patients biopsied and diagnosed with MN from 1996 to 2011, 10 positive for hepatitis B surface antigen were recruited for this study. We investigated the clinical courses, therapeutic responses, and prognoses of patients with HBV-MN. RESULTS: The incidence of HBV-MN among the original 89 patients was 11.2%. Of these patients, four were treated with supportive care and six with antiviral drugs. One of the four patients treated with supportive care had a spontaneous remission. Four of the six patients treated with antiviral drugs were given lamivudine, and the other two were given entecavir. Two of the four patients treated with lamivudine achieved complete remission with seroconversion (i.e., development of anti-hepatitis B e antigen antibodies), whereas the other two had lamivudine-resistant strains, which were detected at 22 and 23 months after lamivudine treatment, respectively. We added adefovir to the treatment regimen for one of these patients, and for the other patient we substituted clevudine for lamivudine. Both of these patients experienced complete remission, as did the two patients initially treated with entecavir, neither of whom showed resistance to the drug. CONCLUSIONS: New nucleoside analogues, such as entecavir, adefovir, and clevudine, can be effective for treatment of HBV-MN, including lamivudine-resistant strains.
Adenine/analogs & derivatives/therapeutic use ; Adult ; Antiviral Agents/*therapeutic use ; Arabinofuranosyluracil/analogs & derivatives/therapeutic use ; Drug Resistance, Viral ; Female ; Glomerulonephritis, Membranous/*drug therapy/*etiology ; Guanine/analogs & derivatives/therapeutic use ; Hepatitis B, Chronic/*complications/*drug therapy ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Organophosphonates/therapeutic use ; Young Adult

Aino virus infection is characterized by abortion, stillbirth, and congenital abnormalities such as arthropgryposis-hydranencephaly syndrome in calves. In Korea, Aino virus infection was first reported in 1997 by researchers who were investigating the cause of newborn calf deformities. Given the incidence of Aino-related deformities, the need for a study of the Aino virus infection status in Korea was recognized. In this study, we investigated the nationwide seroepidemiological status of Aino virus infection. A total of 9,921 serum samples collected between 1993 and 2001, and 23,760 serum samples between 2002 and 2007 were tested using a virus neutralization assay. The seroprevalence of Aino virus was 73.1, 63.8, 44.9, 56.0, 38.5, 28.4 18.3, 19.6, and 23.2%, respectively, between 1993 and 2001, and 43.8, 42.9, 50.7, 55.3, 31.4, and 25.4%, respectively, between 2002 and 2007. Aino virus infection does not pose a major threat to the bovine industry in Korea till now. The future prospects for Aino virus infection in cattle, however, may change with the global warming phenomena. The results of this study may serve as a basis for future epidemiological studies on Aino virus infection.
Animals ; Cattle ; Congenital Abnormalities ; Epidemiologic Studies ; Global Warming ; Humans ; Incidence ; Infant, Newborn ; Korea ; Seroepidemiologic Studies ; Stillbirth ; Viruses

BACKGROUND/AIMS: We investigated the incidence and clinical characteristics of renal cell carcinoma (RCC) in the native kidney of renal transplant recipients. METHODS: Between 1991 and 2010, 1,425 patients underwent kidney transplantation at our institution. We retrospectively evaluated the clinical features and outcomes in renal transplant patients with RCC in the native kidney after renal transplantation. RESULTS: The patients included three males and two females with a mean age of 63 years (range, 52 to 74). The incidence of RCC was 0.35%. The median interval between renal transplantation and RCC occurrence was 16.2 years (range, 9 to 20). All of our patients with RCC had developed renal cysts either before (n = 3) or after (n = 2) renal transplantation. The mean duration of dialysis was 12 months (range, 2 to 39). Of the five patients, four underwent dialysis treatment for less than 8 months. All the RCCs were low grade at the time of diagnosis. Four patients underwent radical nephrectomy, and one patient refused the operation. The four patients who underwent radical nephrectomy showed no evidence of local recurrence or distant metastasis during the median follow-up of 2.9 years. However, the patient who did not undergo surgery developed spinal metastasis from the RCC 6 years later. CONCLUSIONS: This study suggests that the follow-up period is an important factor for the development of RCC in renal transplant recipients, and more vigorous screening with a longer follow-up period is required in renal transplant recipients.
Aged ; Carcinoma, Renal Cell/*epidemiology ; Female ; Humans ; Incidence ; Kidney Neoplasms/*epidemiology ; *Kidney Transplantation ; Male ; Middle Aged ; Postoperative Complications/*epidemiology ; Republic of Korea/epidemiology ; Retrospective Studies

BACKGROUND: Diabetic patients are known to have unusually high mean intraocular pressure (IOP); attributable to autonomic dysfunction and genetic factors. A recent study reported that diabetic complications occur in not only diabetes but also prediabetes. We performed this study to analyze the relationship between glycated hemoglobin A1c (HbA1c) levels and IOP in non-diabetics using electronic medical records at the health screening center of Soon Chun Hyang University Seoul Hospital.METHODS: We considered 16,643 individuals who visited the health screening center of Soon Chun Hyang University Seoul Hospital between November 2015 and September 2017. In total, 3,029 subjects were included in the study. Exclusion criteria included a history of hypertension, diabetes, stroke, cardiovascular disease, hepatitis (A-C), cancer, other disease, fasting blood glucose of 126 mg/dL or higher, HbA1c of 6.5% or higher, and individuals whose binocular IOP could not be measured. We categorized subjects into two groups; those with HbA1c less than or equal to 5.6%, and those with HbA1c greater than 5.6% and less than 6.5%. The mean IOP of each group was compared by gender.RESULTS: After adjusting for factors affecting IOP, analysis of variance was performed to analyze the relationship between HbA1c and IOP. There was no statistically significant difference between the HbA1c groups in males. However, there was a significant difference in IOP between females in the the higher and lower HbA1c groups.CONCLUSION: There was a statistically significant relationship between mean IOP and HbA1c in females without diabetes. Further research is needed with prospective and extensive data collection.
Blood Glucose ; Data Collection ; Diabetes Complications ; Diabetes Mellitus ; Electronic Health Records ; Fasting ; Female ; Health Promotion ; Hemoglobin A, Glycosylated ; Hepatitis ; Humans ; Hypertension ; Intraocular Pressure ; Male ; Mass Screening ; Myocardial Infarction ; Prediabetic State ; Prospective Studies ; Seoul ; Telescopes

Intravascular lymphomatosis is a rare lymphoma characterized by neoplastic proliferation of malignant cells within the lumen of small blood vessels, usually presenting in the central nervous system or on the skin. Intravascular lymphomatosis is manifested clinically by fever, dementia, cutaneous nodules or plaques, and occasionally, dyspnea. The diagnosis of intravascular lymphomatosis is difficult because of misleading clinical features mimiking vasculitis, infection, stroke, or other neoplasm. We report two cases of intravascular lymphomatosis pesented as fever and skin rash. Those are confirmed by involved tissue biopsy. All cases were treated by combination chemotherapy, but the response was not good. Infectious problems were complicated and disease were progressed.
Biopsy ; Blood Vessels ; Central Nervous System ; Dementia ; Diagnosis ; Drug Therapy, Combination ; Dyspnea ; Exanthema ; Fever ; Lymphoma ; Skin ; Stroke ; Vasculitis

BACKGROUND: Since Plasmodium vivax malaria reemerged in Korea in 1993, a number of patients with malaria have been reported. We analyzed the cases with malaria who lived in Chuncheon and neighboring communities to find out clinical manifestations, laboratory findings and the differences in clinical findings compared to previous studies. METHODS: We reviewed the clinical records of the cases who were confirmed as malaria by peripheral blood smear in Chuncheon Sacred Heart Hospital from July, 1998 to Octorber, 2001. RESULTS: Forty-four cases were included. All cases were Plasmodium vivax with high fever, but tertian fever developed only in 15 patients (35.7%). A number of cases showed various symptoms including headache, abdominal pain, nausea, vomiting. Of the all cases, 41 cases (93.2%) developed malaria between June and September. Thrombocytopenia was prominent finding which was noted in 75% of the cases at diagnosis, and recovered during or after treatment. Other laboratory abnormalities such as anemia, elevated transaminases, coagulopathies, and elevated LDH level were also noted. Five patients were performed CSF studies, one patient showed pleocytosis in CSF. CONCLUSION: We observed that only 15 patients (35.7%) had tertian fever, the others had variable fever patterns. Thrombocytopenia was the prominent findings. Therefore we suggest that malaria should be included in the differential diagnosis of febrile diseases which developed from June to September regardless of the fever patterns.
Abdominal Pain ; Anemia ; Diagnosis ; Diagnosis, Differential ; Fever ; Gangwon-do ; Headache ; Heart ; Humans ; Korea ; Leukocytosis ; Malaria ; Malaria, Vivax* ; Nausea ; Plasmodium vivax* ; Plasmodium* ; Thrombocytopenia ; Transaminases ; Vomiting

BACKGROUND: Since its reemergence in 1993, a number of cases of Plasmodium vivax malaria have been reported in Korea. We analyzed the cases of malaria patients living in Chuncheon and its neighboring communities, to characterize its clinical manifestations and laboratory findings, and to identify any differences between our clinical findings and those of previous studies. METHODS: We reviewed the clinical records of cases that were confirmed as malaria by peripheral blood smear at Chuncheon Sacred Heart Hospital from July 1998 to September 2001. RESULTS: Forty-four cases were included in the study. All patients were infected with Plasmodium vivax, and presented with high fever; however, tertian fever developed in only 15 patients (35.7%). A number of cases showed various symptoms, which included headache, abdominal pain, nausea and vomiting. Of the 44 cases identified, 41 (93.2%) developed malaria between June and September. Thrombocytopenia was a prominent finding in 75% of the cases at diagnosis, but resolved during or after therapy. Other laboratory abnormalities such as, anemia, elevated transamines, coagulopathies, and elevated lactose dehydrogenase (LDH) were also noted. Cerebrospinal fluid (CSF) studies were performed in five cases, one of which showed pleocytosis in the CSF. CONCLUSION: We noted only 15 patients (35.7%) with tertian fever; the other patients showed variable fever patterns. Thrombocytopenia was the most prominent laboratory finding. Therefore, we suggest that malaria should be included in the differential diagnosis of febrile diseases with an onset between June to and September, regardless of the pattern of the fever.
Adult ; Animals ; Comparative Study ; Diagnosis, Differential ; Female ; Human ; Malaria/blood/cerebrospinal fluid/*diagnosis/*microbiology ; Male ; Plasmodium vivax/*isolation & purification ; Retrospective Studies ; Thrombocytopenia/diagnosis