We present at least a one-year follow up of the 19 patients(twenty-two hands) of a open release of carpal ligament and external neurolysis in surgery for carpal tunnel syndrome. The transverse carpal ligament is exposed through a three centimeter paJmar incision in line with the axis of the third finger, started at the mid-point of the distal wrist crease and then straightly advanced. We analysed clinical manifestations and the following results were obtained; The average follow-up period was 27 months (12 - 120months). 1. According to the patients satisfaction of results(Cseuz criteria), the large majority of patients(91%) obtained good results. In 9% of the case (two hands) symptoms were siightly improved followed the operation but pain, numbness and paresthesia remained troublesome. 2. The mean grip and pinch strength of the fifteen hands were 23.4kg and 5.97kg respectively. 3. Thirteen(87%) of the fifteen hands that had thenar atrophy regained normal muscle bulk. 4. Six(50%) of the twelve hands that had denervation findings such as fibrillation or sharp wave were disappeared. 5. Twenty(91%) of the twenty-two hands that had increased values for two-point discrimination had normal values at follow-up.
Atrophy ; Axis, Cervical Vertebra ; Carpal Tunnel Syndrome* ; Denervation ; Discrimination (Psychology) ; Fingers ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Hypesthesia ; Ligaments* ; Paresthesia ; Pinch Strength ; Reference Values ; Wrist

PURPOSE: This study was done to evaluate the predictive value of aspects of the Transtheoretical model (TTM) of behavior change as applied to smoking cessation in a rural population. METHOD: A convenience sample was recruited from a public health center in a community. A total of 484 participants were recruited, including 319 smokers, 116 ex-smokers and 49 non-smokers. A cross-sectional and descriptive design was used in this study. Data was analyzed using descriptive statistics, frequency statistics, ANOVA and Logistic regression. RESULT: The major findings were 1) The participants were assessed at baseline for their current Stage of Change resulting in a distribution with 42.1% in Precontemplation, 24.1% in Contemplation, 9.7% in Preparation, 6.2% in Active, and 17.9% in the Maintenance stage. 2) There were statistically significant differences of processes of change, decisional balance and situational temptation across the stages of change. 3) The main factors that affect smoking cessation were age, number of years smoking, age when began smoking, self-liberation and negative/affective situations, which combined explained 33.2% of the smoking cessation. CONCLUSION: TTM variables measured prior to a smoking cessation program added little predictive value for cessation outcome beyond that explained by demographic and smoking history variables.
Tobacco Use Disorder/psychology/rehabilitation ; Smoking Cessation/*psychology ; Rural Population ; *Models, Psychological ; Middle Aged ; Male ; Korea ; Humans ; Female ; Aged ; Adult

OBJECTIVES: The aim of this study was to compare the efficacy and safety of magnesium sulfate, ritodrine hydrochloride and nifedipine in the management of preterm labor. MATERIALS AND METHODS: 180 women with documented preterm labor were randomly assigned to receive magnesium sulfate (n=60), ritodrine hydrochloride (n=60) and nifedipine (n=60) as initial tocolytic therapy. 30 women with documented preterm labor were allocated to administer fluid only and bed rest as control group. Patient could be switched to another tocolytic regimen if they continued to have contractions or side effects. The main outcome variables examined were days gain in utero, success rate, side effects and neonatal outcome. RESULTS: There were no significant differences in maternal characteristics between the groups. The days gain in utero was no statistically different in the three groups(magnesium sulfate, ritodrine hydrochloride and nifedipine) but markedly longer in the three groups than the control group (p<.01). The total success rate was similar in the three groups, but side effects were much more in the magnesium sulfate and ritodrine group than the nifedipine group (p<.05). The respiratory distress syndrome in neonate was decreased in the three groups than the control group without statistical significance. CONCLUSION: Nifedipine is an effective, safe, and well-tolerated tocolytic agent. In this retrospective study, total success rate of controlling preterm labor was similar in the three groups, but patients who received nifedipine were less side effects than magnesium sulfate or ritodrine group.
Bed Rest ; Female ; Humans ; Infant, Newborn ; Magnesium Sulfate ; Magnesium* ; Nifedipine ; Obstetric Labor, Premature* ; Pregnancy ; Retrospective Studies ; Ritodrine* ; Tocolysis

Persistent vesical dysfunction is often encountered after long term bladder overdistension caused by urinary retention. Experimentally, acute overdistension has also been implicated in the pathogenesis of the response to partial outlet obstruction. In the present study, we evaluated the expression of iNOS in the partially obstructed rat bladder and presupposed that NO is responsible for the prolonged micturition problem after partial outlet obstruction of the rat bladder. Female Sprague-Dawley rats weighing 150~200g were used. Individual bladders were obtained from unoperated control rats, and from rats at 6, 12, 48, 72 hours, 5 and 7 days after partial urethral obstruction. Total RNA was extracted from each of these tissue. The expression of mRNAs were assessed by Northern blot analysis. The band intensity of the autoradiographs measured by densitometry were compared between the obstructed and control group. The expression of mRNA for iNOS was detected in the control rats. The expression showed a sharp increase at 6 hours (342% increase) after obstruction and returned to normal by 24 hours. In this study, we show that iNOS increases in the rat bladder after operation and these results suggest that overproduction of NO may be a possible mechanism for the prolonged bladder dysfunction after partial bladder outlet obstruction.
Animals ; Blotting, Northern ; Densitometry ; Female ; Humans ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II* ; Rats* ; Rats, Sprague-Dawley ; RNA ; RNA, Messenger* ; Urethral Obstruction ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urinary Retention ; Urination

Background/Aims: The multidisciplinary team (MDT) approach is a cornerstone of clinical oncology. This study investigated the current state of MDT care, including patient satisfaction, in Korea. Methods: We obtained the annual number of cancer patients who have received MDT care since 2014 from the registry of the Health Insurance Review and Assessment Service (HIRA). In addition, patients who received MDT care from August 2014 to May 2017 at four university hospitals were further characterized, and patient satisfaction was measured prospectively using a patient-reported questionnaire. Results: The total number of patients who received MDT care increased from 2014 to 2016 (2,113 to 9,998 patients, respectively) in the HIRA Cohort. The type of cancer that most often required MDT was breast cancer (23.8%), followed by colorectal cancer (19.1%). In the Representative Cohort (n = 1,032), MDT was requested by the surgeon more than half the time (55.7%). The main focus of MDT was decision making for further treatment planning (99.0%). The number of doctors participating in the MDT was usually five (70.0%). After initiating an MDT approach, the treatment plan changed for 17.4% of patients. Among these patients, 359 completed a prospective satisfaction survey regarding their MDT care. The overall satisfaction with the MDT approach was very high, with an average score of 9.6 out of 10 points. Conclusions The application of MDT care is a rapidly growing trend in clinical oncology, and shows high patient satisfaction. Further research is needed to determine which types of cancer patients could benefit most from MDT, and to enable MDT care to operate more efficiently so that it may expand successfully throughout Korea.

The nephrotic syndrome that occurs in the absence of renal vein thrombosis, amyloidosis, neoplastic infiltration of the kidneys is an unusual but a well recognized paraneoplastic syndrome. The most frequently reported neoplasms associated with nephrotic syndrome are Hodgkin's disease and various carcinomas. The most common renal lesions are membranous glomerulonephritis(MGN) associated with carcinomas and minimal change lesions associated with Hodgkin's disease. Approximately 40% to 45% of patients clinically manifest the MGN symptoms prior to the diagnosis of the tumor, 40% simultaneously with the tumor and the remaining 15% to 20% following the tumor. Therefore, evaluating the underlying malignancy in patients with MGN is important. Here we report a patient with squamous cell lung cancer, which was detected 12 months after a MGN had been diagnosed, with a review of the relevant literature.
Amyloidosis ; Diagnosis ; Glomerulonephritis, Membranous* ; Hodgkin Disease ; Humans ; Kidney ; Lung Neoplasms* ; Lung* ; Nephrotic Syndrome ; Paraneoplastic Syndromes ; Renal Veins ; Thrombosis

Six hundred fifty-one metacarpal bones of Koreans were studied for variations in articular and non-articular surface and the number, position and direction of the diaphyseal nutrient foramina. The facets for articulation of the metacarpal bone with one another showed very frequent variations from the standard text-book description. The number and the sites of entry of the diaphyseal nutrient foramina also showed considerable variations. These findings show no apparent racial difference in variations of metacarpal bones between a Korean and an Indian.
Metacarpal Bones*

The purpose of this study was to demonstrate corticospinal tract compression that was due to a hematoma by using diffusion tensor tractography (DTT) and functional MRI (fMRI) in a patient with an intracerebral hemorrhage (ICH). A 23-year-old right-handed woman presented with severe paralysis of her right extremities at the onset of a spontaneous ICH. Over the first three days from onset, the motor function of the affected upper and lower extremities rapidly recovered to the extent that she was able to overcome applied resistance to the affected limbs, and her limbs regained normal function 3 weeks after onset. The tract of the right hemisphere originated from the primary sensori-motor cortex (SM1) and it passed through the known corticospinal tract pathway. However, the tract of the left hemisphere was similar to that of the right hemisphere except that it was displaced to the antero-medial side by the hematoma at the cerebral peduncle. Only the contralateral SM1 area centered on the precentral knob was activated during affected (right) or unaffected (left) hand movements, respectively. In conclusion, fMRI and DTT demonstrated a corticospinal tract compression due to hematoma in this patient. We conclude that the combined use of these two modalities appears to improve the accuracy of investigating the state of the corticospinal tract.
Spinal Cord Compression/complications/*diagnosis/pathology ; Pyramidal Tracts/*pathology ; *Magnetic Resonance Imaging ; Humans ; Hematoma/complications/*diagnosis/pathology ; Female ; Diffusion Magnetic Resonance Imaging/*methods ; Cerebral Hemorrhage/complications/*diagnosis/pathology ; Adult

PURPOSE: We investigated the relationship between the expression of caveolin-1, using a tissue microarray (TMA), and the prognosis of patients with renal cell carcinoma (RCC). MATERIALS AND METHODS: TMA sections of formalin-fixed, paraffin-embedded tissues of RCC from 82 patients, who had undergone radical nephrectomy, were stained immunohistochemically with specific antibodies against caveolin-1. The caveolin-1 immunostaining was semi-quantitatively estimated based on intensity. The expression pattern of caveolin-1 was compared with the clinicopathological variables. RESULTS: The expression of caveolin-1 was significantly correlated with tumor size (p=0.002), TNM stage (p<0.001), T stage (p=0.001), M stage (p=0.004), grade (p=0.028) and metastasis (p<0.001), and was also significantly higher in clear cell than non-clear cell RCC (p<0.001). The survival of patients with higher caveolin-1 expression was significantly worse than that of patients with lower caveolin-1 expression (p=0.001). Univariate analyses were able to identify all variables, including caveolin-1 expression as significant prognostic factors for cancer-specific survival; multivariate analyses indicated that TNM stage, M stage and grade were independent prognostic factors. Caveolin-1 expression was not an independent factor. CONCLUSIONS: The increased expression of caveolin-1 is associated with tumor size, stage, grade, metastasis and a worse prognosis in RCC, which suggests that caveolin-1 may be important in the progression of RCC.
Antibodies ; Carcinoma, Renal Cell* ; Caveolin 1* ; Humans ; Multivariate Analysis ; Neoplasm Metastasis ; Nephrectomy ; Prognosis*

Age estimation is important in the practice of forensic science to establish the identity of human remains, as well as with living persons. Particularly in Korea, age estimation in adults has been increase in the demand for incorrect birth records in order to be entitled to civil liability, social benefits, employment. The reduction of pulp cavity size as a result of secondary dentin deposit with increasing age could be used to estimate age. This regressive change can be analyzed using radiological techniques; thus, a variety of methods for dental age estimation based on this approach have been proposed. The purpose of this study is to evaluate the concurrence between the Drusini's method and the Jeon's method using the mandibular first molar on orthopantomographs (OPGs) in Korean adults. A total of 232 OPGs (91 females and 141 males) of Korean individuals with ages ranging from 20 to 69 years were analyzed using Drusini's method and Jeon's method. Our results revealed that the correlation of the two methods with age was statistically significant (r=0.501). Both Drusini's method and Jeon's method showed significant correlation with chronological age, and Jeon's method showed a greater correlation with chronological age (r=0.738) than Drusini's method (r=0.586). The mean absolute error was 7.99 years for Jeon's method and 9.79 years for Drusini's method. Our results demonstrate that Jeon's method using the mandibular first molar on OPGs is a practical and suitable method for age estimation in Korean adults.
Adult* ; Age Determination by Teeth ; Birth Certificates ; Dentin ; Dentin, Secondary ; Employment ; Female ; Forensic Sciences ; Humans ; Korea ; Methods* ; Molar* ; Radiography