From retrospective review of 111 tibial fractures treated by interlocking intramedullary nailing, 38 operative errors in 28 cases(25%) were included in this study. The errors were classified into two categories. The first category included eighteen errors that related to fracture reduction; nine angular malalignments, four failures in closed nailing to open the fracture site, two peroneal nerve palsies, two shortenings of tibial length(more than 1cm), and one rotational malalignment. The second category comprised twenty errors that related to the nailing itself; eight protrusions of proximal nail tip, five overdistractions of fracture gap (more than 3mm), four additional fragmentations, two mistakes in interlocking screw insertion, and one ankle joint injury by the distal nail tip. Functional results of those 28 cases at the last follow-up(average, 17.5 months; range, 9 to 29 months) were excellent or good in only 60.8 per cent, while the control group treated by adequate operative technique showed excellent or good results in 92.8 per cent.
Ankle Joint ; Fracture Fixation, Intramedullary ; Paralysis ; Peroneal Nerve ; Retrospective Studies ; Tibial Fractures

PURPOSE: Anaplastic thyroid carcinoma is characterized with rapid growing mass of the neck and early infiltration into the surrounding tissue. Because of its advanced presentation in elderly patients with poor general condition, difficulty in diagnosis and lack of effective treatment, it is one of the most lethal cancers in human. The aim of this study was to investigate the clinicopathologic character of anaplastic thyroid carcinoma and analyze the prognostic factors affecting survivals. METHODS: Twenty patients diagnosed anaplastic thyroid carcinoma in Seoul National University Hospital between 1985 and 1999 were reviewed retrospectively. RESULTS: The most common symptom was a rapidly enlarging neck mass. Ten (55.5%) of 18 patients had a concomitant well differenciated thyroid carcinomas and 5 (27.8%) patients had benign thyroid disease on pathologic features. The median survival was 5.5 months and the 2-year survival rate was 27.3%. Among several factors analyzed, tumor size smaller than 5 cm (p<0.001), absence of distant metastases at presentation (p=0.020), patients selected for curative surgical resection (p=0.002), and postoperative radiotherapy (p=0.003) were associated with prolonged survival time. CONCLUSION: In the selected patients(tumor size <5 cm, the absence of distant metastases at presentation, young age (<55), curative surgical resection and adjuvant radiotherapy may be associated with an increased survival time.
Aged ; Diagnosis ; Humans ; Neck ; Neoplasm Metastasis ; Radiotherapy ; Radiotherapy, Adjuvant ; Retrospective Studies ; Seoul ; Survival Rate ; Thyroid Carcinoma, Anaplastic* ; Thyroid Diseases ; Thyroid Neoplasms

PURPOSE: Anaplastic thyroid carcinoma is characterized by a rapid growing mass of the neck and an early infiltration into the surrounding tissue. Because of its mature expression in elderly patients who have a poor general physical condition, a difficulty in diagnosis and the lack of effective treatment, it is one of the most lethal cancers that occur in human. The aim of this study was to investigate the clinicopathologic character of anaplastic thyroid carcinoma and analyze the prognostic factors affecting the survival rate. METHODS: The history of twenty patients who were diagnosed as having anaplastic thyroid carcinoma at Seoul National University Hospital between 1985 and 1999 were reviewed retrospectively. RESULTS: The most common symptom was a rapidly enlarging neck mass. Ten (55.5%) of 18 patients had concomitant well differentiated thyroid carcinomas and 5 (27.8%) patients had benign thyroid disease on the basis of the presenting pathologic features. The median survival time was 5.5 months and the 2-year survival rate was 27.3%. Among several factors that were analyzed, a tumor size smaller than 5 cm (p<0.001), the absence of distant metastases at presentation (p=0.020), patients that were selected for curative surgical resection (p=0.002), and postoperative radiotherapy (p=0.003) were associated with prolonged survival time. CONCLUSION: In the selected patients (tumor size<5 cm, the absence of distant metastases at presentation, young age (<55)), curative surgical resection and adjuvant radiotherapy may result in an increased survival time.
Aged ; Diagnosis ; Humans ; Neck ; Neoplasm Metastasis ; Radiotherapy ; Radiotherapy, Adjuvant ; Retrospective Studies ; Seoul ; Survival Rate ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Neoplasms*

OBJECTIVE: To determine the effect of the addition of Vit. D3 (1,25-Dihydroxychole calciferol D3) to the conventional postmenopausal hormone replacement therapy on bone mineral density(BMD) DESIGN: A 2-year retrospective , randomized study Setting : Department of Obstetrics and Gynecology of Catholic university hospital Patients : 388 postmenopausal women were recruited and divided into 5 groups according to treatment regimen; A: conjugated estrogens only treated group(n=146), B : conjugated estrogens and progesterone treated group(n=103), C : conjugated estrogens and Vit.D3 treated group (n=36), D : conjugated estrogens, progesterone and Vit.D3 treated group (n=41), E : control group (n=60). METHODS: The bone mineral density of the lumbar spines and femoral neck were determined by dual-energy X-ray absorptiometry(DEXA) every 2 years. STATISTICS: The difference between before and after treatment was determined by paired t-test. The comparison among the groups were determined by one way ANOVA test and student's t-test. RESULTS: The addition of progesterone to estrogen showed insignificant increase in the lumbar and femoral neck BMD. The addition of Vit. D3 compared with conventional hormone replacement therapy insignificantly influened bone density in women with initially normal BMD, but definitely increase in women with initially osteopenic and osteoporotic BMD of femoral neck rather than lumar spine(p<0.05). CONCLUSIONS: The use of Vit. D3 combined with postmenopausal estrogen replacement effects the increase of BMD in low bone density than normal bone density, especially femoral neck.
Bone Density* ; Estrogen Replacement Therapy ; Estrogens ; Estrogens, Conjugated (USP) ; Female ; Femur Neck ; Gynecology ; Hormone Replacement Therapy ; Humans ; Obstetrics ; Progesterone ; Retrospective Studies ; Spine ; Vitamins*

Small cell carcinoma commonly originates in the lung, with only about 4% of cases arising at extrapulmonary sites. Furthermore, small cell carcinoma of the sinonasal tract is extremely rare. In Korea, only 2 cases of primary sinonasal small cell carcinoma have been reported in the nasal cavity and the nasal septum, respectively. Recently, we have experienced a rare case of small cell carcinoma arising from the right maxillary sinus coexisting with a fungal ball lesion. Herein, we report this case with a review of the literature.
Aspergillosis ; Carcinoma, Small Cell* ; Fungi* ; Korea ; Lung ; Maxillary Sinus* ; Nasal Cavity ; Nasal Septum

BACKGROUND AND OBJECTIVES: Postnasal drip is a common presentation to the medical practitioner. It is a result of disturbance to the normal drainage or an increase in secretion of the paranasal sinuses. However, sometimes no underlying cause can be found and the patient has to be reassured, and that they may just have to live with it. The aim of this study is to evaluate the clinical manifestations of patients with postnasal drip. MATERIAL AND METHOD: There were 90 patients complaining with postnasal drip. We performed a prospective study about accompanying symptoms and physical and psychiatric evaluation. CONCLUSION: Postnasal drip is more common in females over 30 years and the duration of symptoms is usually long. Anatomical nasal abnormality and sinusitis are common. There is no correlation with postnasal drip and psychiatric problems. But several items are concerned with postnasal drip. So we need detailed history taking and physical examination on patients who complained of postnasal drip.
Drainage ; Female ; Humans ; Paranasal Sinuses ; Physical Examination ; Prospective Studies ; Sinusitis

OBJECTIVES: The purpose of this study was to assess the risk of ingestion exposure of lead by particle sizes of crumb rubber in artificial turf filling material with consideration of bioavailability. METHODS: This study estimated the ingestion exposure by particle sizes (more than 250 um or less than 250 um) focusing on recyclable ethylene propylene diene monomer crumb rubber being used as artificial turf filling. Analysis on crumb rubber was conducted using body ingestion exposure estimate method in which total content test method, acid extraction method and digestion extraction method are reflected. Bioavailability which is a calibrating factor was reflected in ingestion exposure estimate method and applied in exposure assessment and risk assessment. Two methods using acid extraction and digestion extraction concentration were compared and evaluated. RESULTS: As a result of the ingestion exposure of crumb rubber material, the average lead exposure amount to the digestion extraction result among crumb rubber was calculated to be 1.56x10(-4) mg/kg-day for low grade elementary school students and 4.87x10(-5) mg/kg-day for middle and high school students in 250 um or less particle size, and that to the acid extraction result was higher than the digestion extraction result. Results of digestion extraction and acid extraction showed that the hazard quotient was estimated by about over 2 times more in particle size of lower than 250 um than in higher than 250 um. There was a case of an elementary school student in which the hazard quotient exceeded 0.1. CONCLUSIONS: Results of this study confirm that the exposure of lead ingestion and risk level increases as the particle size of crumb rubber gets smaller.
Alkenes ; Biological Availability ; Digestion ; Eating ; Ethylenes ; Humans ; Particle Size ; Risk Assessment ; Rubber

Isolated thyroid stimulating hormone (TSH) deficiency is very rare. Only a few patients are reported in the world. A 50-year-old woman was admitted to Soonchunhyang University Cheonan Hospital because of a distal radius fracture. She was diagnosed with hypothyroidism incidentally. Serum free T4 and TSH were low. After administration of exogenous TSH releasing hormone, no TSH response was noted. The response of prolactin and other pituitary hormones were appropriate after stimulation. Pituitary magnetic resonance image did not reveal any abnormalities. The diagnosis of isolated TSH deficiency was established for this patient.
Congenital Hypothyroidism ; Female ; Humans ; Hypothyroidism ; Magnetic Resonance Spectroscopy ; Pituitary Hormones ; Prolactin ; Radius Fractures ; Thyroid Gland ; Thyrotropin

BACKGROUND AND OBJECTIVES: Diagnosis of nasal bone fracture is important because of not only deformity of the external nose but also because of other additional injuries around the nose. The purpose of this study is to explore the incidence, type, location and direction of nasal septal fracture in nasal bone fracture patients who were diagnosed by nasal bone CT. SUBJECTS AND METHOD: We analysed the medical records and films of 135 nasal bone fracture patients who were diagnosed by computerized tomography from January 2005 to September 2005. The nasal bone fracture was classified by six types on nasal bone CT: unilateral, bilateral, open book, impacted, greenstick, comminuted. The external deviation of nasal bone (20 degree below or up) and correlation between septal fracture and nasal bone fracture were analysed by chi-square test (p<0.05). RESULTS: The incidence of each type of nasal bone fracture is unilateral (41%), bilateral (18%), open book (8%), impacted (6%), green stick (17%), and comminuted (10%). The incidence of combined septal fracture was high in comminuted and impacted rather than in unilateral and bilateral (p<0.05). And there was no correlation between the directions of the trauma force and nasal septal deviation. CONCLUSION: The incidence of concurrent nasal septal fracture when nasal bone fracture occur is relatively high, so we must consider nasal septum more carefully on nasal trauma.
Congenital Abnormalities ; Diagnosis ; Humans ; Incidence ; Medical Records ; Nasal Bone* ; Nasal Septum ; Nose

Background: An ideal lung allocation system should reduce waiting list deaths, improve transplant survival, and ensure equitable organ allocation. This study aimed to develop a novel lung allocation score (LAS) system, the MaxBenefit LAS, to maximize transplant benefits. Methods: This study retrospectively analyzed data from the Korean Network for Organ Sharing database, including 1,599 lung transplant candidates between September 2009 and December 2020. We developed the MaxBenefit LAS, combining a waitlist mortality model and a post-transplant survival model using elastic-net Cox regression, was assessed using area under the curve (AUC) values and Uno’s C-index. Its performance was compared to the US LAS in an independent cohort. Results: The waitlist mortality model showed strong predictive performance with AUC values of 0.834 and 0.818 in the training and validation cohorts, respectively. The post-transplant survival model also demonstrated good predictive ability (AUC: 0.708 and 0.685). The MaxBenefit LAS effectively stratified patients by risk, with higher scores correlating with increased waitlist mortality and decreased post-transplant mortality. The MaxBenefit LAS outperformed the conventional LAS in predicting waitlist death and identifying candidates with higher transplant benefits. Conclusion The MaxBenefit LAS offers a promising approach to optimizing lung allocation by balancing the urgency of candidates with their likelihood of survival post-transplant. This novel system has the potential to improve outcomes for lung transplant recipients and reduce waitlist mortality, providing a more equitable allocation of donor lungs.