No abstract available.
Pancytopenia*

Nasal bone fracture is the most common fracture among facial fractures. The nasal bone fracture has a very complex and infinitive variety but often is undermanaged only by closed reduction. The prognosis and outcome after operation had been reported by many surgeons and it's result is dependant upon many factors such as etiology, experience of surgeons, type of anesthesia and maintenance of fixation after surgery. In our study, we have grouped our fractures as favorable and unfavorable fractures. Favorable fractures are simple fractures that are easily reduced by closed reduction, whereas unfavorable fractures were fractures that remain unstable after reduction. In our opinion, the method of reduction and fixation after reduction plays an important role in unfavdrable fracture. We applied a new method of external fixation for unfavorable fractures After closed reduction to gain optimal reduction and maintenance.
Anesthesia ; Nasal Bone* ; Prognosis

No abstract available.
Biphasic Insulins

BACKGROUND: The purpose of this study was to evaluate change in glycosylated hemoglobin (HbA1c), side effects, and quality of life (QOL) after a 16-week treatment period with Biphasic insulin aspart 30/70 (BIasp30) in patients with type 2 diabetes mellitus (T2DM) who had been suboptimally controlled with oral antidiabetic drugs (OADs). METHODS: The study consisted of a 4-week titration period when concurrent OAD(s) were replaced with BIasp30 and followed by a 12-week maintenance period. All patients completed the Diabetes Treatment Satisfaction Questionnaire at the beginning and the end of the trial. Hypoglycemic episodes were recorded by the patient throughout the trial. RESULTS: Sixty patients were included, of whom 55 patients (92%) completed the full 16-week treatment period. Seven-point blood glucose was significantly improved as compared with the baseline, except for the postlunch blood glucose level. HbA1c at the end of period was significantly improved from 9.2% to 8.2% (P<0.001). Eleven percent (n=6) of patients achieved HbA1c values < or =6.5% and 22% (n=12) of patients achieved <7.0%. There were 3.4 episodes/patients-year of minor hypoglycemia and 0.05 episodes/patients-year of major hypoglycemia. QOL showed significant changes only in the acceptability of high blood glucose category (P=0.003). CONCLUSION: Treatment with once or twice daily BIasp30 may be an option for the patients with T2DM suboptimally controlled with OADs in Korea. However, considering the low number of patients achieving the HbA1c target and the high postlunch blood glucose levels, additional management with another modality may be required for optimal control.
Biphasic Insulins ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Hemoglobin A, Glycosylated ; Humans ; Hypoglycemia ; Hypoglycemic Agents ; Insulin Aspart ; Insulin, Isophane ; Korea ; Quality of Life

PURPOSE: DNA in most cell is regularly damaged by endogenous and exogenous mutagens. Unrepaired damage resulted in apoptosis or may lead to unregulated cell growth and cancer. Inheritance of genetic variants at one or more loci results in an reduced DNA repair capacity. These polymorphisms are highly prevalent in the population, and therefore the attributable risks for cancer could be high. Several studies have documented that polymorphisms of XRCC1, XPD and XRCC3 are associated with skin cancer, especially, XRCC1 among of them has been reported frequently. So, this study involves the relationship between mutation of XRCC1 of squamous cell and basal cell cancer of the skin and risk of cancer development in Korean population. METHODS: In case control study, study population (n=100, each cancer) is patients who were pathologically diagnosed as skin cancer(squamous cell carcinoma and basal cell carcinoma) in Yonsei Wonju Christian Hospital and Bundang CHA General Hospital between 1998 and 2004. The samples of DNA from whom no history of premalignant skin lesion and other malignant diseases were reported belonged to the control group(n=210). Blood and tissue samples were analyzed for presence of XRCC1 Arg399Glu, Arg280His, Arg194Trp using PCR/ RFLP method. RESULTS: For Korean, there was a significant correlation between XRCC1 Arg399Gln gene mutation and risk of basal cell carcinoma development(Arg 399Gln(GA), p=0.012, OR=2.016, 95% CI; 1.230-3.305) /Arg399Gln (AA), p=0.011, OR=1.864, 95% CI; 1.149-3.026)). And, there was also significant correlation between XRCC1 Arg194Trp and risk of skin squamous cell carcinoma development (Arg194Trp (CT+TT), p=0.041, OR=0.537, 95% CI; 0.301-0.960)). In contrast, there was no significant correlation between XRCC1 Arg280His and risk of either basal cell carcinoma or squamous cell carcinoma development. CONCLUSION: Our result present that XRCC1 Arg399 Gln in basal cell carcinoma and XRCC1 Arg194Trp in squamous cell carcinoma have possibility of cancer risk and biomarker in Korean population. But XRCC1 Arg280 His known having cancer risk on other studies is not associated with cancer risk to squamous cell carcinoma and basal cell carcinoma in Korean population.
Apoptosis ; Carcinoma, Basal Cell* ; Carcinoma, Squamous Cell* ; Case-Control Studies ; DNA Repair* ; DNA* ; Gangwon-do ; Hospitals, General ; Humans ; Mutagens ; Neoplasms, Basal Cell ; Polymorphism, Restriction Fragment Length ; Skin Neoplasms ; Skin* ; Wills

Fournier's gangrene is life-threatening disease characterized by abrupt onset of a rapidly progressive necrotizing soft tissue infection involving the perineum and scrotum. In Fournier's original descriptions, the disease arose in healthy subjects without an obvious cause. Despite controversy still surrounds its etiology, current studies identify definite urologic and colorectal causes with its combined disease in a majority of cases. We experienced cases of large scrotal and perineal defect caused by Fournier's gangrene. Aggressive and extensive debridement with a parenteral broad spectrum antimicrobial agents was executed at the important points to the treatment. The patient also received adjuvant hyperbaric oxygen therapy. The clinical efficacy of hyperbaric oxygen was discussed. After control of infection and unavoidable loss of soft tissue, the major concern following Fournier's gangrene lies on the protection of the testicles and adequate volumetric scrotal appearance. The defect was successfully reconstructed with unilateral or bilateral gracilis muscle flap transposition and split- thickness skin graft. We present this article utilizing bilateral gracilis muscle flaps as an acceptable alternative in the approach to scrotal reconstruction in Fournier's gangrene.
Anti-Infective Agents ; Debridement ; Fournier Gangrene* ; Humans ; Hyperbaric Oxygenation ; Oxygen ; Perineum ; Scrotum ; Skin ; Soft Tissue Infections ; Testis ; Transplants

OBJECTIVES: This study aimed to investigate the 10-year risk of cardiovascular disease (CVD) by Framingham risk score (FRS) who classified as "healthy group" by Korean Occupational Safety and Health Agent (KOSHA)' s cardiovascular risk assessment. METHODS: The subjects of this study were 1,781 male workers in a large steel company. Health status was obtained periodically through medical examinations and questionnaires. We assessed cardiovascular risk using KOSHA guidelines and calculated the 10-year risk of cardiovascular disease using the Framingham risk score for those categorized to the "healthy group" by KOSHA guideline. A closer examination of cardiovascular risk factors was performed in 62 subjects paradoxically placed in the "healthy group" by KOSHA guidelines and the "high-risk group" by FRS. RESULTS: Among the "healthy group" by KOSHA's cardiovascular risk assessment, 230(15.8%) subjects had more than 3 CVD risk factors and 62(4.2%) subjects were high risk group (more than 20%) in 10-years risk of CVD by Framingham risk score. Modifiable risk factors included cigarette smoking (96.8%), high serum total cholesterol (82.3%), high serum triglyceride (66.1%), insufficient physical activity (66.1%), and obesity (58.1%). CONCLUSIONS: Among subjects with normal blood pressure, it seems that KOSHA guidelines underestimate CVD risk, identified by the Framingham risk score. For the effective prevention and management of CVD, modifiable risk factors, such as cigarette smoking, dyslipidemia, and obesity, need to be constructively controlled.
Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Dyslipidemias ; Humans ; Male ; Motor Activity ; Obesity ; Occupational Health ; Questionnaires ; Risk Assessment ; Risk Factors ; Smoking ; Steel

Wernicke encephalopathy is an acute neurologic disorder attributable to thiamine (vitamin B1) deficiency. We report the case of a 61-year-old female patient who presented Wernicke encephalopathy after surgery for pancreatic head cancer. From the ninth postoperative day, she had suffered from nausea and vomiting and had difficulties ingesting food, she was given total parenteral nutrition (TPN), but lacked adequate vitamin (thiamine) supplementation. After 28 days, she developed ataxia, ophthalmoplegia, and mental confusion. The magnetic resonance image showed pathologic changes in the medial thalamus, periaqueductal gray matter, medulla and mamillary bodies. The blood level of thiamine was very low. After intravenous and oral supplementation of thiamine (200 mg/day), consciousness was soon normalized and neurologic symptoms have gradually been improving. Nausea and vomiting disappeared after administration of a low dose of mirtazapine (7.5 mg/day). We emphasize the importance of thiamine supplementation to the patients who suffer from vomiting which hinders them from taking food and who require prolonged TPN.
Ataxia ; Consciousness ; Female ; Head and Neck Neoplasms ; Humans ; Mamillary Bodies ; Middle Aged ; Nausea ; Nervous System Diseases ; Neurologic Manifestations ; Ophthalmoplegia ; Pancreaticoduodenectomy* ; Parenteral Nutrition, Total ; Periaqueductal Gray ; Thalamus ; Thiamine ; Vitamins ; Vomiting* ; Wernicke Encephalopathy*

BACKGROUND: This study's aim is to compare the correlates of instrumental and physical activities of daily living (ADL) according to the presence or absence of dementia in an elder populated community. METHODS: This study was part of a community survey of late-life psychiatric morbidity carried out in Kwangju, South Korea in 2001. The Instrumental Activities of Daily Living Scale was administered to 740-community residents aged 65 or over. Data on the demographic characteristics (age, gender, living area, marital state, and religion), socio-economic state (education, monthly income, number of rooms, previous occupation, current employment, and social network), and clinical characteristics (cognitive function, physical illness, and depression) were gathered. RESULTS: The instrumental ADL impairment was associated significantly with higher age and lower cognitive functional ability in both groups. However, the impairment was shown in those without dementia, currently unemployed and had no spouse. The physical ADL impairment was significantly associated with lower cognitive function and higher number of physical illnesses in those with dementia, while it was significantly associated with higher age and severe depressive symptoms in those without dementia. The accountability portion of the above correlates for the variances of the instrumental and physical ADL was high in those with dementia, but was unacceptably low in those without dementia. CONCLUSIONS: It was suggested that the correlates and utility of ADL scale might vary according to dementia state.
Activities of Daily Living* ; Aged* ; Aging ; Surveys and Questionnaires ; Dementia ; Depression ; Employment ; Gwangju ; Humans ; Korea ; Motor Activity ; Neurobehavioral Manifestations ; Occupations ; Social Responsibility ; Spouses

No abstract available.
Lymphoma, Large-Cell, Anaplastic