PURPOSE: To demonstrate the effectiveness of the conservative treatment which was introduced to the extraarticular triplane fractures of the distal tibia. MATERIALS AND METHODS: We reviewed radiographs and medical records of eight patients with extraarticular triplane fractures of the tibia. Four patients were treated with closed reduction and internal fixation and the others with closed reduction and plaster. RESULTS: In all patients, the union of fractures was obtained. Although the physes were closed early, there was no angular deformity or leg length discrepancy. CONCLUSION: In case of extraarticular triplane fracture, except for open fracture or failure of closed reduction, conservative treatment yield good result.
Child* ; Congenital Abnormalities ; Fractures, Open ; Humans ; Leg ; Medical Records ; Tibia*

STATEMENT OF PROBLEM: Many dental clinicians are concerned about immediate loading of inserted implants. However, there have been few clinical studies surveying the success rates of immediate loading, based on Korean implant systems. PURPOSE: The aim of this study was to evaluate the outcome of immediate functional loading of the implant (SinusQuick(TM) EB, Neobiotech Co., Seoul, Korea) in partially edentulous maxilla or mandible. MATERIAL AND METHODS: Total 15 implants were placed. Within 2 weeks after implant insertion, provisional implant-supported fixed partial dentures were delivered to the patients. Quantitatively, marginal bone loss was measured at the time of immediate loading, after 3-months of continued loading and at the last follow-up. The mean follow-up period was 4.8 months. RESULTS: Mean marginal bone loss from implant surgery to early loading, 3-months follow-up and last follow-up was 0.03 +/- 0.07 mm, 0.16 +/- 0.17 mm and 0.29 +/- 0.19 mm. No implant failed up to 6 months after insertion, resulting in a 100% survival rate. CONCLUSION: Immediate loading exhibited high success rate in partial edentulism for up to 6 months. Well-controlled long term clinical studies with large sample size are necessary to confirm this finding.
Dental Implants ; Denture, Partial, Fixed ; Follow-Up Studies ; Humans ; Mandible ; Maxilla ; Prospective Studies ; Sample Size ; Survival Rate

The nerve conduction study with the inching method has been performed to characterize the nature of lesion (focal of diffuse) within the carpal tunnel and to increase the diagnostic sensibility of the carpal tunnel syndrome (CTS). The sensory nerve conduction velocity of finger-to-palm (F-P) segment of median never or the ratio of sensory nerve conduction velocity of palm-to-wrist (PW) segment to F-P segment of the median nerve (P-W/F-P ratio) was also measured to differentiate the CTS from the early peripheral polyneuropathy, which may only involve the median nerve. Conduction times of the sensory median nerve between the midpalm and the distal forearm in 2cm increments were measured orthodromically in controls (n=32) and CTS patients. The P-W/F-P ratio in control, CTS without diabetes mellitus (DM) (n=23), CTS with DM (n=9), and diabetic peripheral polyneuropathy (DP) groups was compared. The criteria for focal lesion within the carpal tunnel were defined as follows 1) If the maximal conduction time is located at 4-2cm segment distal(designated as '-') to distal wrist crease, it must be prolonged more than 4 times that of the adjoining distal segment or 6 times that of adjoining proximal segment. 2) If the maximal conduction time is located at -6--4cm segment, it must be beprolonged more than 4 times that of the adjoining proximal segment. According to above criteria, the incidened of focal lesion within the carpal tunnel was 84.4%(27/32) and the most common segment of focal lesion was -4--2cm segment(85.2%, 23/27). The P-W/F-P ratio was more decreased in CTS without DM (0. 55 + 0. 11) and CTS with DM(O.68+0.07) groups than control(0382+0.09) and DP(O.81+0.09) groups(P<0.01). In CTS groups, it was more decreased in CTS without DM group than CTS with DM group(p<0.05). So the measurement of sensory nerve conduction velocity of F-P segment of median nerve or the P-W/F-P ratio is helpful not only to evalucate the early distal involvement of peripheral neuropathy but also to establish the subclinical involvement of the segment distal to transverse carpal ligament in CTS with DM group.
Carpal Tunnel Syndrome* ; Diabetes Mellitus ; Forearm ; Humans ; Ligaments ; Median Nerve ; Neural Conduction ; Peripheral Nervous System Diseases ; Polyneuropathies ; Wrist

No abstract available.
Antineoplastic Agents/therapeutic use ; Bone Marrow Cells/pathology ; Cladribine/therapeutic use ; DNA Mutational Analysis ; Female ; Humans ; Immunophenotyping ; Leukemia, Hairy Cell/*diagnosis/drug therapy/*genetics ; Middle Aged ; *Mutation ; Proto-Oncogene Proteins B-raf/*genetics ; Reticulin/metabolism

A 41-year-old female complaining of easy fatigue, headache, thickened extremities and deepened facial folds was admitted to the hospital. As early as 6 years ago, she had been told by family members that her voice was changed and both hands was thickened. Cranial plain radiography indicated ballooning of sella turcica. Sella MRI disclosed 2.2cm sized pituitary tumor with suprasellar extension. The pituitary tumor with hypothalamic extension was removed via a transsphenoidal approach. The postoperative course was uneventful until hyponatremia with sudden headache and respiratory arrest was developed. The case was due to hyponatremic encephalopathy on the basis of the clinical course and symptoms, and 3% hypertonic saline was infused for 12 hours until the hyponatremia was corrected. We have experienced a mortality case of hyponatremic encephalopathy in which surgieal removal of a pituitary tumor from a female acromegalic patient in menstruant period was followed by the sudden occurrence of hyponatremia, which in turn was later associated with marked brain edema.
Adult ; Brain Edema ; Extremities ; Fatigue ; Female ; Hand ; Headache ; Humans ; Hyponatremia ; Magnetic Resonance Imaging ; Mortality ; Pituitary Neoplasms ; Radiography ; Sella Turcica ; Voice

OBJECTIVES: To assess innate and humoral immune responses in middle ear effusion of obese pediatric patients with otitis media with effusion (OME). METHODS: We evaluated 219 children with OME, of whom 21 were obese and 198 were non-obese. We compared the expression in middle ear effusion of mRNAs encoding toll-like receptors (TLR) 2, 4, 5, and 9; nucleotide-binding oligomerization domains (NOD) 1 and 2; retinoic acid-inducible gene (RIG)-I; interleukins (IL)-6, -10, and -12; interferon (IFN)-gamma; and tumor necrosis factor (TNF)-alpha mRNAs. We also compared the expression of immunoglobulins IgG, IgA, and IgM and the bacterial detection rate in the two groups. RESULTS: TLR2-mediated expression of IL-6 mRNA, TLR4-mediated expression of IL-6 and IL-10 mRNA, TLR5-mediated expression of IL-6, IL-10, and TNF-alpha mRNA, TLR9-mediated expression of IL-6 mRNA, and NOD2-mediated expression of IL-6, IL-12, and TNF-alpha mRNA were significantly lower in obese than in non-obese children (P<0.05). However, concentrations of IgG, IgA, and IgM in middle ear effusion were lower in obese than in non-obese children, but none of these differences was significant (P>0.05). CONCLUSION: Mean body mass index was higher and pattern-recognition receptor-mediated cytokine mRNA expression was lower in obese than in non-obese children with OME.
Bacteria ; Body Mass Index ; Child* ; Humans ; Immunity, Humoral ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Interferons ; Interleukin-10 ; Interleukin-12 ; Interleukin-6 ; Interleukins ; Obesity ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; RNA, Messenger* ; Toll-Like Receptors ; Tumor Necrosis Factor-alpha

Red cell antigens, A, B, and H can be weakened or lost especially in patients with hematologic malignancies. We report a 42-year-old female patient with acute myeloid leukemia, who showed loss of A antigen on her red cells. She showed the persistence of leukemia in spite of three cycles of induction chemotherapy. Her ABO blood group showed a discrepancy: the cell type was O and the serum type was A. Adsorption/elution test could not identify the presence of A antigen on her red cells, and the test for A and B transferases was negative. ABO genotyping using PCR/restriction fragment length polymorphism and sequencing of exons 6 and 7 of the ABO gene demonstrated 467 C>T substitution in exon 7 and confirmed the genotype of A102/O01. She was transfused with leukapheresis products collected from donors with blood group A, but expired of severe sepsis. This is the first Korean case, in which red cell A antigen loss was genetically proven using sequencing, and underscores the necessity of ABO genotyping to solve the ABO discrepancy and to transfuse effectively.
Adult ; Exons ; Female ; Genotype ; Hematologic Neoplasms ; Humans ; Induction Chemotherapy ; Leukapheresis ; Leukemia ; Leukemia, Myeloid, Acute ; Sepsis ; Tissue Donors ; Transferases

No abstract available.
Duodenal Ulcer* ; Humans ; Recurrence*

BACKGROUND: The purpose of this study was to determine the appropriate exercise intensity associated with maximum fat oxidation, improvement of body composition, and metabolic status in Korean women with type 2 diabetes mellitus (T2DM). METHODS: The study included a T2DM group (12 women) and a control group (12 women). The groups were matched in age and body mass index. The subjects performed a graded exercise test on a cycle ergometer to measure their maximal fat oxidation (Fatmax). We also measured their body composition, metabolic profiles, and mitochondrial DNA (mtDNA). RESULTS: The exercise intensity for Fatmax was significantly lower in the T2DM group (34.19% maximal oxygen uptake [VO2 max]) than the control group (51.80% VO2 max). Additionally, the rate of fat oxidation during exercise (P<0.05) and mtDNA (P<0.05) were significantly lower in the T2DM group than the control group. The VO2 max level (P<0.001) and the insulin level (P<0.05) were positively correlated with the rate of fat oxidation. CONCLUSION: The results of this study suggest lower exercise intensity that achieves Fatmax is recommended for improving fat oxidation and enhancing fitness levels in Korean women with T2DM. Our data could be useful when considering an exercise regimen to improve health and fitness.
Body Composition ; Body Mass Index ; Diabetes Mellitus, Type 2* ; DNA, Mitochondrial ; Exercise Test ; Female ; Humans ; Insulin ; Metabolome ; Oxygen

PURPOSE: Most treatment decisions for breast cancer patients are based on an assesment of prognostic factors. Tumor markersB (p53, c-erbB2, bcl-2, Cathepsin D) have been evaluated for their prognostic factors and many studies suggest that these factors as assessed by immunohistochemistry (IHC) may be helpful for treatment decisions, while the risk group for high relapse can not be discriminated by single tumor marker alone. In order to obtain useful prognostic information, several tumor marker expressions must be combined and weighted. METHODS: The expressions of ER, PR, p53, c-erbB2, bcl-2, Cathepsin D were detected by IHC on paraffin-embedded sections from 449 primary breast cancer patients treated at Seoul National University Hospital between January 1996 and December 1998. In the present study, tumor marker expressions were analyzed along with conventional clinicopathologic factors. Additionally, correlations between various tumor marker expressions were examined and combinations of tumor marker expressions relating pathologic parameters currently in use for primary breast cancer prognosis were investigated. RESULTS: ER, PR, bcl-2, Cathepsin D expressions were related to smaller tumor size and PR was related to less axillary nodal involvement. ER, PR, bcl-2 expressions were related to good NG and HG, while p53 expression wasrelatedto poor NG and HG. ER and PR expression were related to bcl-2 expression, c-erbB2 expression was related to p53 expression and c-erbB2 expression was related to Cathepsin D expression. ER /bcl-2 was more prevalent in NG 1 and HG III tumors. ER /p53 and p53 /bcl-2 were more prevalent in NG 2/3 and HG I/II tumors. p53 /c-erbB2 was more prevalent in NG 1 tumors. CONCLUSION: Combinations of tumor marker expressions ER/bcl-2, ER/p53, p53/c-erbB2, p53/bcl2 provides more detailed information concerning cancer aggressiveness.
Breast Neoplasms* ; Cathepsin D* ; Cathepsins* ; Equidae ; Humans ; Immunohistochemistry ; Prognosis ; Recurrence ; Seoul