PURPOSE: To determine the locations and incidences of sesamoids and accessory bones of the forefoot in normal Korean adults. MATERIALS AND METHODS: The plain radiographs of the forefoot of 400 volunteers, 200 males and 200 females, were taken. The three orthopedic surgeons participated in the radiographic evaluation independently. Persons who had history of foot problem or injury were excluded. RESULTS: Sesamoids of first metatarsophalangeal joint were nearly always present; medial 99% and lateral 100%. The bipartite sesamoid was more common in medial (9.8%) and in female (17.0%) than in lateral (0.3%) and in male (2.5%). Sesamoids of the interphalangeal joint of the first toe were seen in 35.8%. Sesamoids of metatarsophalangeal joints in other four toes were rarely observed. Their incidences were 5% in second toe, 0.8% in third, 0% in fourth, and 2.8% (lateral) and 7.5% (medial) in fifth. Sesamoids of interphalangeal joint in four lesser toes were not observed except two cases (0.5%) in the fifth toe. Accessory bone was very rarely observed. Os vesalianum was observed in five feet (1.3%), Os intermetatarseum in 14 feet (3.5%), and Os cuneo-metatarsal I tibiale in none. CONCLUSION: We determined the location and incidences of sesamoids and accessory bones of the forefoot, and we expected this to help to diagnose the forefoot problem.
Adult* ; Female ; Foot ; Humans ; Incidence ; Joints ; Male ; Metatarsophalangeal Joint ; Orthopedics ; Toes ; Volunteers

PURPOSE: We compared the bony arrangements of the forefoot in 2 different years, 1982 and 2004, to determine any changes with time period of 22 years. MATERIALS AND METHODS: The radiographs of 200 normal Korean adults, 100 male and 100 female volunteers, were evaluated both in 1982 and 2004. The radiographic results were evaluated with as follows; hallux valgus angle (HVA), intermetatarsal angle (IMA), morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges. The mean ages were 38 years (23-52years) in 1982, and 37 years (24-50years) in 2004. RESULTS: The mean of HVA decreased from 15.6 degrees in 1982 to 14.3 degrees in 2004 (p=0.047), and the mean of IMA increased from 8.0 degrees in 1982 to 9.4 degrees in 2004 (p=0.031). The morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges were not different between the two study years. CONCLUSION: Comparing with those of 1982 measurements, we found an increase of IMA and a decrease of HVA. A prospective study may be needed to illuminate course of the changes.
Adult ; Female ; Hallux Valgus ; Head ; Humans ; Male ; Metatarsal Bones ; Volunteers

PURPOSE: To determine the locations and incidences of sesamoids and accessory bones of the forefoot in normal Korean adults. MATERIALS AND METHODS: The plain radiographs of the forefoot of 400 volunteers, 200 males and 200 females, were taken. The three orthopedic surgeons participated in the radiographic evaluation independently. Persons who had history of foot problem or injury were excluded. RESULTS: Sesamoids of first metatarsophalangeal joint were nearly always present; medial 99% and lateral 100%. The bipartite sesamoid was more common in medial (9.8%) and in female (17.0%) than in lateral (0.3%) and in male (2.5%). Sesamoids of the interphalangeal joint of the first toe were seen in 35.8%. Sesamoids of metatarsophalangeal joints in other four toes were rarely observed. Their incidences were 5% in second toe, 0.8% in third, 0% in fourth, and 2.8% (lateral) and 7.5% (medial) in fifth. Sesamoids of interphalangeal joint in four lesser toes were not observed except two cases (0.5%) in the fifth toe. Accessory bone was very rarely observed. Os vesalianum was observed in five feet (1.3%), Os intermetatarseum in 14 feet (3.5%), and Os cuneo-metatarsal I tibiale in none. CONCLUSION: We determined the location and incidences of sesamoids and accessory bones of the forefoot, and we expected this to help to diagnose the forefoot problem.
Adult* ; Female ; Foot ; Humans ; Incidence ; Joints ; Male ; Metatarsophalangeal Joint ; Orthopedics ; Toes ; Volunteers

PURPOSE: We compared the bony arrangements of the forefoot in 2 different years, 1982 and 2004, to determine any changes with time period of 22 years. MATERIALS AND METHODS: The radiographs of 200 normal Korean adults, 100 male and 100 female volunteers, were evaluated both in 1982 and 2004. The radiographic results were evaluated with as follows; hallux valgus angle (HVA), intermetatarsal angle (IMA), morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges. The mean ages were 38 years (23-52years) in 1982, and 37 years (24-50years) in 2004. RESULTS: The mean of HVA decreased from 15.6 degrees in 1982 to 14.3 degrees in 2004 (p=0.047), and the mean of IMA increased from 8.0 degrees in 1982 to 9.4 degrees in 2004 (p=0.031). The morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges were not different between the two study years. CONCLUSION: Comparing with those of 1982 measurements, we found an increase of IMA and a decrease of HVA. A prospective study may be needed to illuminate course of the changes.
Adult ; Female ; Hallux Valgus ; Head ; Humans ; Male ; Metatarsal Bones ; Volunteers

The purpose of this study was to compare the fracture strength of the IPS Empress ceramic crown according to the occlusal depth (1.5mm, 2.0mm, 2.5mm) and axial inclination (4degree, 8degree, 12degree) of the lower First Molar. After 10 metal dies were made for each group, the IPS Empress ceramic crowns were fabricated and cemented with resin cement(Bistite resin cement, Tokuyama Soda Co. LTD., Japan). The cemented crowns were mounted on the testing jig with inclination of 30 degrees and the universal testing machine(Zwick Z020, Zwick, Germany)was used to measure the fracture strength. The results of this study were as follows : 1. The fracture strength of the ceramic crown with 2.5mm depth and 12degree inclination was the highest (1789 N). Crowns of 1.5 mm depth and 4degree inclination had the lowest strength (1091 N). 2. There were no significant differences in the fracture strength by axial inclination of the same occlusal depth group. 3. Most fracture lines began at the loading area and extended through proximal surface perpendicular to the margin, irrespective of occlusal depth. Size of fragment was affected by the amount of occlusal reduction.
Ceramics ; Crowns* ; Molar* ; Resin Cements

BACKGROUND: Smoking is the most important and consistent determinant of the development and progression of COPD(Ed Note : Define COPD). The fact that cigarette smokers develop a different type of COPD, chronic bronchitis and emphysema, with different clinical and pathological aspects, suggests that the development of COPD has a relationship with other smoking-associated factors beyoud just a simple smoking history. The aim of this was to analyze the smoking habits and history of patients with COPD and to evaluate the development of different types of COPD accordint to patient's smoking habits. METHOD: To evaluate the differences in the smoking patterens of patients with chronic bronchitis and emphysema, a pulmonary function test was conducted, and the smoking history and patterns was obtained through a smoking history questionnaire by a direct personal interview from 333 male cigarette smokers diagnosed with COPD, in the Yeungnam university medical center(190 patients diagnosed with chronic bronchitis, 143 patients diagnosed with emphysema). RESULT: The patients with emphysema smoked earlier and had a higher smoking history(ie, more pachyears, more total amounts of smoked cigarette, and more deep inhalation and longer duration of plain cigarette exposure) than those with chronic bronchitis. The depth of ingalation was also significantly higher in the emphysema patients after taking into account age, cumulative cagarette consumption and the type of cigarette smoked. CONCLUSION: Emphysema was more associated with the increasing degree of inhalation as assessed by the depth of inhalation. A high alveolar smoke exposure may be a significant risk factor for the development of emphysema.
Bronchitis, Chronic* ; Emphysema* ; Humans ; Inhalation ; Male ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Risk Factors ; Smoke* ; Smoking* ; Tobacco Products

Paraganglioma is a tumor from the extra adrenal paraganglion system and is rarely observed in the mediastinum. The authors experienced a case of nonfunctioning paraganglioma of the posterior mediastinum. The patient was 34-years-old male in whom abnormal mass lesion was nites in chest radiograph with hemoptysis. His blood pressure and serologic examination were within normal range upon admission to our hospital. Chest CT revealed a tumor in the left lower lobe. Diagnostic thoracoscopy was performed and diagnosed a posterior mediastinal mass. Surgical resection was them performed. Posterior mediastinal mass was removed successfully and histological examination of the surgical specimen diagnosed paraganglioma. He received radiotherapy after surgery and was followed up. Related literature are reviewed.
Blood Pressure ; Hemoptysis ; Humans ; Male ; Mediastinum* ; Paraganglioma* ; Radiography, Thoracic ; Radiotherapy ; Reference Values ; Thoracoscopy ; Tomography, X-Ray Computed

An abnormal dipping pattern in ambulatory blood pressure monitoring (ABPM) is a cardiovascular (CV) risk factor. However, its impact on CV mortality has not been investigated sufficiently in clinical practice to be considered a standard parameter. We assessed the association between abnormal dipping patterns and increased CV mortality in a tertiary hospital in Korea. Our retrospective cohort study included 401 patients who underwent ABPM between 1994 and 1996 in Hanyang University Hospital, Seoul, Korea. The patients were classified as risers (<0% drop in systolic BP; n=107), and others included dippers and non-dippers (> or =0% drop, n=294). The follow-up period was 120 months. The frequency of CV mortality was 14.0% in risers and 5.8% in others. A Cox regression analysis found a significant association between dipping pattern and CV mortality, after adjusting for age, gender, body mass index, hypertension, diabetes mellitus, smoking and hypercholesterolemia. Risers were at greater risk of CV death than others (RR, 3.02, P=0.022), but there was no difference in event rates between dippers and non-dippers. The reverse dipping pattern may be more frequent in clinical settings than in the population at large, and it is strongly associated with increased risk of CV mortality in Korea.
Adult ; Age Factors ; Aged ; Blood Pressure/*physiology ; Blood Pressure Monitoring, Ambulatory ; Body Mass Index ; Cardiovascular Diseases/*mortality ; Cohort Studies ; Female ; Humans ; Hypertension/complications ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Predictive Value of Tests ; Regression Analysis ; Retrospective Studies ; Risk Factors ; Sex Factors

BACKGROUND AND PURPOSE: Recent randomized clinical trials (RCTs) have demonstrated benefits of endovascular recanalization therapy (ERT) contrary to earlier trials. We aimed to estimate the benefits of ERT added to standard therapy in acute ischemic stroke. METHODS: From a literature search of RCTs testing ERT, we performed a meta-analysis to estimate an overall efficacy and safety of ERT for all trials, stent-retriever trials, and RCTs comparing ERT and intravenous tissue plasminogen activator (IV-TPA). RESULTS: We identified 15 relevant RCTs including 2,899 patients. For all trials, ERT was associated with increased good outcomes (odds ratio [OR] 1.79; 95% confidence interval [CI] 1.34, 2.40; P<0.001) compared to the control. ERT also increased no or minimal disability outcomes, good neurological recovery, good activity of daily living, and recanalization. ERT did not significantly increase symptomatic intracranial hemorrhage (SICH) (OR 1.19; 95% CI 0.83, 1.69; P=0.345) or death (OR 0.87; 95% CI 0.71, 1.05; P=0.151). In contrast, ERT significantly reduced extreme disability or death (OR 0.77; 95% CI 0.61, 0.97; P=0.025). Restricting to five stent-retriever trials comparing ERT plus IV-TPA vs. IV-TPA alone, the benefit was even greater for good outcome (OR 2.39; 95% CI 1.88, 3.04; P<0.001) and extreme disability or death (OR 0.57; 95% CI 0.41, 0.78; P=0.001). Restricting to eight RCTs comparing ERT (plus IV-TPA in six trials) with IV-TPA alone showed similar efficacy and safety. CONCLUSIONS: This updated meta-analysis shows that ERT substantially improves clinical outcomes and reduces extreme disability or death without significantly increasing SICH compared to standard therapy.
Humans ; Intracranial Hemorrhages ; Stroke* ; Thrombectomy ; Tissue Plasminogen Activator

The hallmarks of sleep apnea syndrome include daytime hypersomnolence, snoring, obesity, disturbed nocturnal sleep, and apneic episodes. Thyroid deficiency states are now a well recognized cause of sleep apnea. Central, obstructive, and mixed patterns of sleep apnea may be observed in hypothyroidism. A 33-yr-old man was admitted complaining of daytime hypersomnolence, snoring, sleep apnea and obesity. A polysomnogram showed obstructive pattern of sleep apnea syndrome. Physical examination and hormonal study revealed a narrowing of the upper airway and primary hypothyroidism. Dilated cardiomyopathy was diagnosed by echocardiogram. The poctients was treated for obstructive sleep apnea syndrome with nasal continuous positive airway pressure(CPAP) for 2 months and the underlying hypothyroidism with thyroid hormone therapy. This successfully controlled the snoring, sleep apnea, and other apnea-related symptoms. Here, we describe our experience of nasal CPAP and thyroid hormone therapy in a patient with primary hypothyroidism associated with obstructive sleep apnea syndrome and dilated cardimyopathy with review of the relevant literature.
Cardiomyopathies ; Cardiomyopathy, Dilated* ; Disorders of Excessive Somnolence ; Humans ; Hypothyroidism* ; Obesity ; Physical Examination ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Thyroid Gland