Dislocation involving talus is a rare injury comprising less than 1% of all dislocations of the joint. One case of lateral subtalar di location of the talus treated at the Department of Orthopedic Surgery, Kang Nam General Hospital in Decernber 1985. The patient was followed for 6 months and satisfactory healing was obtained.
Dislocations ; Hospitals, General ; Humans ; Joints ; Orthopedics ; Talus

Thirteen patients were operated for cubital tunnel syndrome and followed for an average of 26 months postoperatively. Ten patients had a history of relevant trauma and three patients had degenerative osteoarthritis of the elbow. The average duration of symptoms was 18 months (range, 2 to 96 months). Diagnosis was made by physical examination, electromyography and nerve conduction study. Among these, nerve conduction study was found to be the most valuable diagnostic method for the patients with atypical clinical findings. Most of the operations were performed by anterior transposition of the ulnar nerve. At the most recent follow-up, the result was excellent in two patients, good in eight, and fair in three; thus ten patients(77%) showed satisfactory results. The rating system for ulnar neuropathy based on sensory, motor dysfunction and pain was useful for evaluating the operative results. The postoperative gain of score for pain and sensory function were larger than that of motor function. Factors known to influence the result of the operation (age, duration of symptom, history of trauma, method of operation) did not effect the outcome in this study. For successful operation, the ulnar nerve must be thoroughly examined, all possible levels of compression must be released and new foci of compression must be created.
Cubital Tunnel Syndrome ; Diagnosis ; Elbow ; Electromyography ; Follow-Up Studies ; Humans ; Methods ; Neural Conduction ; Osteoarthritis ; Physical Examination ; Sensation ; Ulnar Nerve ; Ulnar Neuropathies

Objective: This study evaluates the general clinico-toxicological characteristics, and determines whether they are varied with toxin source, in patients admitted to the hospital and diagnosed with grayanotoxin (GTX)/mad honey poisoning. Methods: Patients diagnosed with GTX/mad honey poisoning at the University Teaching Hospital emergency department between January 2001 and December 2015 were included in this retrospective study. The clinico-toxicological characteristics were compared by classifying patients into two groups, according to the toxin source: group A, poisoned by the Himalayan mad honey, and group B, poisoned by biologic materials containing GTX other than Himalayan mad honey. Results: Totally, 26 patients were identified with symptomatic grayanotoxin/mad honey poisoning. There were no statistical differences in the clinico-toxicological characteristics, except systolic blood pressure (SBP). At presentation, the SBP was significantly decreased in group B (P=0.013). Although dizziness and blurred vision were statistically not significant symptoms, there was a trend of significance (P<0.1) in group B. Notably, 5 of the 8 patients who consumed Rhododendron brachycarpum complained of blurred vision, and had a relatively low mean SBP (68.6±15.6 mmHg). Conclusion The general clinico-toxicological characteristics were similar, subsequent to ingestion of Himalayan mad honey and Rhododendron species. However, since blurred vision and hemodynamic instability were relatively more common in poisoning by R. brachycarpum than other Rhododendron species, emergency physicians need to be aware that the symptoms or severity of poisoning may vary according to the Rhododendron species ingested.

Objective: This study evaluates the general clinico-toxicological characteristics, and determines whether they are varied with toxin source, in patients admitted to the hospital and diagnosed with grayanotoxin (GTX)/mad honey poisoning. Methods: Patients diagnosed with GTX/mad honey poisoning at the University Teaching Hospital emergency department between January 2001 and December 2015 were included in this retrospective study. The clinico-toxicological characteristics were compared by classifying patients into two groups, according to the toxin source: group A, poisoned by the Himalayan mad honey, and group B, poisoned by biologic materials containing GTX other than Himalayan mad honey. Results: Totally, 26 patients were identified with symptomatic grayanotoxin/mad honey poisoning. There were no statistical differences in the clinico-toxicological characteristics, except systolic blood pressure (SBP). At presentation, the SBP was significantly decreased in group B (P=0.013). Although dizziness and blurred vision were statistically not significant symptoms, there was a trend of significance (P<0.1) in group B. Notably, 5 of the 8 patients who consumed Rhododendron brachycarpum complained of blurred vision, and had a relatively low mean SBP (68.6±15.6 mmHg). Conclusion The general clinico-toxicological characteristics were similar, subsequent to ingestion of Himalayan mad honey and Rhododendron species. However, since blurred vision and hemodynamic instability were relatively more common in poisoning by R. brachycarpum than other Rhododendron species, emergency physicians need to be aware that the symptoms or severity of poisoning may vary according to the Rhododendron species ingested.

Basal cell carcinomas(BCCs) are the most common skin cancers in Korea and a proportion of BCCs contain pigment. Pigmented basal cell carcinomas(PBCCs) are included in the differential diagnosis of invasive melanoma and other benign pigmented skin lesions(PSLs) because of their growth patterns and asymmetry of pigmentation. Epiluminescence microscopy(ELM) describes the non-invasive in vivo examination of skin lesions with a microscope using incident light delivered from an acute angle and oil immersion. Many studies have shown that epiluminescence microscopy can improve the diagnostic accuracy of PSLs. Menzies et al analyzed the morphologic features of a large set of 142 pigmented BCCs and produced a simple ELM method for diagnosis that would allow differentiation from melanomas and benign pigmented lesions. We observed morphologic features of two PSLs with a handheld 10 epiluminescence microscopy (Episcope, Welch Allyn Inc, Skaneateles Falls, NY). After the ELM examination, two PSLs were excised and processed for histopathology. The ELM findings and histopathologic diagnosis were compared for each lesion. ELM permits the recognition of two PBCCs and the fact that it is a non-invasive in vivo method makes it even more attractive as a diagnostic tool in clinical practice.
Carcinoma, Basal Cell* ; Dermoscopy* ; Diagnosis ; Diagnosis, Differential ; Immersion ; Korea ; Melanoma ; Pigmentation ; Skin ; Skin Neoplasms

PURPOSE: Patients with bladder pain syndrome/interstitial cystitis (BPS/IC) can have pain as a main symptom and overactive bladder (OAB) symptoms that are directly or indirectly related to a major mechanism that causes pain. The primary purpose of this study is firstly to identify the prevalence rate of OAB symptoms in patients with BPS/IC, secondly to identify changes in OAB symptoms after low-dose triple therapy, and thirdly to build a theoretical foundation to improve quality of life for patients. METHODS: Patients who met the inclusion criteria of BPS/IC through basic tests including the O'Leary-Sant symptom index, overactive bladder symptom score (OABSS), and visual analog scale (VAS) were identified. Treatment-based changes in OAB symptoms were identified using the IC Symptom Index and IC Problem Index (ICSI/ICPI), OABSS, and VAS before, and 4 and 12 weeks after low-dose triple therapy. RESULTS: The patients consisted of 3 men and 20 women, and their mean age was 61.9 years (41.0-83.2 years). Comparing values before treatment, and 4 and 12 weeks after treatment (baseline vs. 4 weeks to baseline vs. 12 weeks), the rates of improvement were as follows: ICSI, 44.2% to 63.7%; ICPI, 46.9% to 59.4%; OABSS, 34.3% to 58.2%; and VAS, 53.6% to 75.0%, which showed statistically significant differences (P<0.05). However, comparing values at 4 and 12 weeks after treatment (4 weeks vs. 12 weeks), the ICSI and VAS showed a statistically significant decrease (P<0.05). The ICPI and OABSS showed slight improvement, but no statistically significant differences (P>0.05). CONCLUSIONS: Low-dose triple therapy in BPS/IC results in a clear decrease in OAB symptoms in the first 4 weeks after treatment, and additional treatment for 8 weeks had a partial effect with varied statistical significances depending on the questionnaires.
Amines ; Amitriptyline ; Cyclohexanecarboxylic Acids ; Cystitis ; Cystitis, Interstitial ; Female ; gamma-Aminobutyric Acid ; Humans ; Male ; Prevalence ; Quality of Life ; Sperm Injections, Intracytoplasmic ; Urinary Bladder ; Urinary Bladder, Overactive

Plunging nasal tip is named on all situations with a long and drooping nose at rest. The severity increases with aging. Morphologically, the nose appears to invade the upper lip, which causes cosmetic problems. In more severe cases, the inspired air flow may be disturbed, leading to functional nasal obstruction. Plunging nasal tip is occasionally termed as smiling tip by some authors. We have classified the plunging nasal tip into 3 categories, based on the McCarthy's classification but with modification, which is more suitable for Asians. The study was undertaken with patients whose nasal tip looks like invade the upper lip, even at rest. In Type I(severe type) the nasal septum is long, invading the lip, and with intact attachment of the alar cartilage to the septal angle. Type II(moderate to mild type) is when the loose attachment of the alar cartilage to the septal angle makes the nasal tip appear drooping, but those less severe than type I. In Type III(pseudo type) the location of the nasal tip is relatively appropriate but, due to maxillary protrusion, the tip looks as if it covers the upper lip. The open rhinoplasty technique was applied regardless of the classified type. Dorsal augmentation, tip plasty, interdomal suture of alar cartilage or detatchment of depressor septi nasi muscle were selectively used when required in all patients. In type I, the removal of caudal septum, cephalic lateral crus resection, anchoring suture of the alar cartilage on the septal angle, and columella strut were concomitantly undertaken. The resection of the cephalic lateral crus, anchoring suture of the alar cartilage on the septal angle and columella strut were applied in type 2. Cephlic lateral crus resection and columella strut were done in type 3. We have made a follow up on 13 patients for up to 6.5 years, who had undergone surgery between March, 1993 to september, 2001. We could get excellent results with no definite re-drooping of nasal tip in all cases.
Aging ; Asian Continental Ancestry Group ; Cartilage ; Classification* ; Follow-Up Studies ; Humans ; Lip ; Nasal Obstruction ; Nasal Septum ; Nose ; Rhinoplasty* ; Smiling ; Sutures

PURPOSE: To assess the long-term follow-up results of laparoscopic pyeloplasty for ureteropelvic junction obstruction. MATERIALS AND METHODS: Sixty-five patients (mean age, 43.8 years) who underwent standard laparoscopic pyeloplasty by transperitoneal approaches were enrolled in this study. The chief complaint was flank pain (n=57 patients); the remaining cases were detected incidentally. Twenty-three patients had undergone previous abdominal surgeries, including open pyeloplasty and endopyelotomy. Mean stricture length was 1.06 cm. Grade 3/4 and 4/4 hydronephrosis was detected in 36 and 14 patients, respectively. An obstructive pattern was present on the renal scan in 53 patients (81.5%). RESULTS: Fifty-seven patients were treated with dismembered Anderson-Hynes pyeloplasty and eight patients with Fenger pyeloplasty. During the operation, crossing vessels were found in 27 patients (41.5%). Mean operating time was 159.42 minutes. Although there were no cases of open conversion, two patients with colon and spleen injuries were detected postoperatively. The mean starting time of postoperative ambulation and diet was 1.54 days and 1.86 days, respectively. Mean hospital stay was 8.09 days. Mean follow-up period was 36.5 months. Follow-up intravenous pyelography and renal scan showed improvements in 59 patients, and the radiologic success rate was 90.8%. Eight patients showed failure on radiologic or symptomatic evaluation, and the overall success rate was 87.7%. In the comparative analysis between the success and failure groups, drained amount was the only risk factor related to failure (554.41 mL. vs. 947.70 mL, p=0.024). CONCLUSIONS: Long-term follow-up results support laparoscopic pyeloplasty as the standard treatment for ureteropelvic junction obstruction. Drained amount is a risk factor for failure of the operation.
Adolescent ; Adult ; Aged ; Child ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis/*congenital/pathology/surgery ; Kidney Pelvis/surgery ; Laparoscopy/adverse effects/methods ; Male ; Middle Aged ; Multicystic Dysplastic Kidney/pathology/*surgery ; Risk Factors ; Severity of Illness Index ; Treatment Failure ; Treatment Outcome ; Ureteral Obstruction/pathology/*surgery ; Young Adult

Transverse skeletal deficiency is a common clincal problem associated with narrow basal and dentoalveolar bone. The clinical characteristics of transverse deficiency presents with anterior crowding and posterior buccal crossbite. Orthodontic expansion, using lip bumper and functional devices, was recommanded for younger ages. However, expansion of lower anterior area in older patients is unstable and tends to relapse toward the original dimension. Distraction osteogenesis is a unique form of clincal tissue engineering and biologic process of new bone formation between bone segments that are gradually separately by incremental traction. Distraction osteogenesis was considered that great potential for correcting transverse mandibular deficiencies. In this paper, a case of treated transverse deficiency patients with distraction osteogenesis using tooth-borne and tooth & bone-borne distractor is presented.
Crowding ; Humans ; Lip ; Malocclusion ; Osteogenesis ; Osteogenesis, Distraction* ; Recurrence ; Tissue Engineering ; Tooth ; Traction