No abstract available.
Biopsy, Fine-Needle* ; Breast*

Interlocking medullary nails have been widely used in the treatment of long bone fractures especially in tibia and femur. But with increasing use of nails, many preoperative, intra-operative and post-operative complications have been reported. We have experienced 3 cases of very rare complication, fracture of tibia shaft which occurred during removal of interlocking medullary nail after complete healing of original tibial fracture. We report these rare complications with literature review.
Femur ; Fractures, Bone ; Tibia* ; Tibial Fractures

In orthopedic practice, patients sometimes ask certain kinds of medical documents certifying their disability grading. But many orthopedic surgeons are not accustomed to issue such medical certificates. So we want to review the way of evaluation and grading of disabilities for such different kinds of medical certificates(for examples: disability grading certificate for use in traffic accident, industrial accident, liability of national compensation, private insurance, the handicapped, military service and others) and compare the differences between them.
Accidents, Occupational ; Accidents, Traffic ; Compensation and Redress ; Disability Evaluation ; Disabled Persons ; Humans ; Insurance ; Military Personnel ; Orthopedics*

The benign mesenchymoma, in which fibrous tissue is accompanied by two or more mesencymal components, occurs very rarely in the head and neck area. The majority appear in patients under 25 years of age, most commonly in the subcutaneous scalp, cheek, or tongue. There is a 20% recurrence rate. Wide surgical excision is the treatment of choice. We report a case of mesenchymoma in the nasopharynx which was removed by transpalatine approach with a brief review of literature.
Cheek ; Head ; Humans ; Mesenchymoma* ; Nasopharynx ; Neck ; Recurrence ; Scalp ; Tongue

PURPOSE: The prevalence of female bladder outlet obstruction(BOO) is not well known and the diagnostic criteria is uncertain. We attempted to find out the features of urodynamic and clinical findings of bladder outlet obstruction in female patients with lower urinary tract symptom. MATERIALS AND METHODS: A total of 251 patients who were referred to urodynamic study for lower urinary tract symptom was available for analysis. Patients who had previous pelvic surgery history or neurologic causes were excluded. History taking, physical examination, voiding diary, urodynamic study were performed. Urodynamic study consisted of free uroflow, urethral pressure profile, cystometry, and pressure flow studies. The criteria of bladder outlet obstruction was peak flow rate at free uroflow less than 12ml/s and detrusor pressure at a maximum flow rate of more than 20cmH2O. Among the patients who were revealed as stress urinary incontinence, but with no other abnormalities at urodynamic study, 30 served as the controls. RESULTS: In 251 patients, 42(16.7%) were BOO patients. There were no significant differences in the clinical features of the two groups, such as age, parity, surgical history. In the urodynamic study, the first voiding sense and maximal bladder capacity were similar in the two groups. Peak flow rate was 24.0+/-10.9ml/s in the control and 7.9+/-1.7ml/s in BOO, the detrusor pressure of maximum flow was 25.8+/-10.4cmH2O and 62.6+/-33.1cmH2O, maximal urethral closing pressure was 55.3+/-20.3cmH2O and 79.5+/-46.8cmH2O, voiding volume was 377.2+/-85.0ml/s and 281.0+/-104.3ml/s, and residual volume was 19.3+/-76.9ml/s and 48.7+/-80.0ml/s, respectively. CONCLUSIONS: Among the female patients who had low urinary tract symptoms, numerous patients were revealed as BOO. BOO must be considered for female patients who have low urinary tract symptoms, and urodynamic studies may play an important role for the diagnosis and treatment of BOO.
Diagnosis ; Female* ; Humans ; Parity ; Physical Examination ; Prevalence ; Residual Volume ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urinary Incontinence ; Urinary Tract* ; Urodynamics

PURPOSE: This study was performed to evaluate the changes in tear film and ocular surface after dacryocystorhinostomy (DCR) in patients with primary acquired nasolacrimal duct obstruction. METHODS: Forty subjects who showed successful results at three months after endoscopic DCR were investigated. The changes in tear breakup time (BUT), basal secretion test (BST), corneal sensitivity test (CST), tear clearance rate (TCR) and keratoepitheliopathy (KEP) were evaluated. RESULTS: The mean age was 57.4+/-13.2 years (29~77 years). Preoperative BST and BUT in eyes which underwent DCR were 13.21+/-3.79 mm and 8.20+/-2.30 seconds, respectively. Three months after the operation, the respective values were 9.13+/-3.77 mm (p=0.01) and 6.27+/-2.20 seconds (p=0.03). Preoperative CST, TCR and KEP in eyes which underwent DCR were 57.89+/-4.18 mm, 3.26+/-0.91 and 0.12+/-0.53, respectively. Three months after the operation, the respective values were 57.75+/-3.55 mm (p=0.32), 3.04+/-0.87 (p=0.08) and 0.13+/-0.54 (p=0.08). No changes were observed between the preoperative and postoperative tear parameters in fellow eyes. CONCLUSIONS: The changes in tear film parameters including BST and BUT should be considered in patients who receive endoscopic DCR.
Dacryocystorhinostomy ; Eye ; Humans ; Nasolacrimal Duct ; Tears

OBJECTIVE: The effect of induced hypothermia on severe acute carbon monoxide (CO) poisoning remains to be addressed further. We investigated the effect of induced hypothermia on severe acute CO poisoning. METHODS: Retrospective chart review was conducted for patients who diagnosed as severe acute CO poisoning in emergency department and underwent induced hypothermia from May 2013 to May 2014. Hospital courses with critical medication and major laboratory results were investigated through the chart review. RESULTS: Among total 227 patients with acute CO poisoning during the period of study, patients with severe acute CO poisoning were 15. All patients underwent induced hypothermia with a temperature goal 33°C. Initial and follow-up levels of S100B protein after induced hypothermia were 0.47 μg/L (interquartile range, 0.11 to 0.71) and 0.10 μg/L (interquartile range, 0.06 to 0.37), respectively (P = 0.01). The mean Glasgow Coma Scales at emergency department admission was 6.87 ± 3.36. Except 1 patient who expired after cardiopulmonary resuscitation, Glasgow Coma Scales at 30-day of hospital discharge were 15 in 10 patients (71.4%), 14 in 1 patient (7.1%), 13 in 1 patient (7.1%), and 6 in 2 patients (14.2%). Seven patients (46.7%) developed delayed neurologic sequelae. Four patients showed mild types of delayed neurologic sequelae and 3 showed moderate to severe types of delayed neurologic sequelae. CONCLUSION: Most of patients underwent induced hypothermia had a good recovery from severe acute CO poisoning. Therefore, induced hypothermia may be considered as a possible treatment in severe acute CO poisoning.
Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Cardiopulmonary Resuscitation ; Coma ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Hypothermia, Induced* ; Poisoning ; Retrospective Studies ; Weights and Measures

Suction-assisted lipectomy has become an increasingly popular procedure, being one of the most frequently performed aesthetic procedures in Korea. Serious complications of suction-assisted lipectomy are uncommon but aesthetic problems are often troublesome. Here we report a patient with multiple abdominal masses composed of fat necrosis with fibrosis after suction- assisted lipectomy that was treated with excision. We also discussed and deduced the cause of its complication because plastic surgeons are liable to overlook this rare complication.
Fat Necrosis ; Fibrosis ; Humans ; Korea ; Lipectomy*

The wound healing effect of topical application of the recombinant human epidermal growth factor(rhEGF) on full-thickness dermal injury was investigated. Two full-thickness excisions were made on the back of the experimental animals. The rhEGF was applied twice a day and the rate of wound closure was measured every day for 14 days. On the seventh postoperative day, the histological findings of epithelization and granulation were examined by Massons tichrome stain, and immunohistochemical staining for proliferating cell nuclear antigen (PCNA) and alpha-smooth muscle actin(alpha-SMA). The wound size was a significant reduction in the rhEGF treated groups as compared with the control group (p<0.05). However, there was no statistical difference in the wound size among the concentrations of the rhEGF treated group. Histological examination revealed that epithelization and granulation was increased significantly in the rhEGF group compared to control group (p < 0.01, 0.05). PCNA and alpha-SMA immunoreactive cells were observed at the margin of wound and the rhEGF treatments significantly increased the number of PCNA and alpha-SMA immunoreactive cells as compared to those of control group (p < 0.01, 0.05). Taken together, these findings suggest that rhEGF enhance the epithelial wound healing by the stimulate of cell proliferation. The wound contraction might be also affected by rhEGF application.
Animals ; Cell Proliferation ; Epidermal Growth Factor* ; Humans* ; Proliferating Cell Nuclear Antigen ; Rats* ; Skin* ; Wound Healing ; Wounds and Injuries*

OBJECTIVE: To define the risk factors that influence the occurrence of venous thromboembolism (VTE) in patients with acute or subacute brain lesions and to determine the usefulness of D-dimer levels for VTE screening of these patients. METHODS: Medical data from January 2012 to December 2013 were retrospectively reviewed. Mean D-dimer levels in those with VTE versus those without VTE were compared. Factors associated with VTE were analyzed and the odds ratios (ORs) were calculated. The D-dimer cutoff value for patients with hemiplegia was defined using a receiver operating characteristic (ROC) curve. RESULTS: Of 117 patients with acute or subacute brain lesions, 65 patients with elevated D-dimer levels (mean, 5.1+/-5.8 mg/L; positive result >0.55 mg/L) were identified. Logistic regression analysis showed that the risk of VTE was 3.9 times higher in those with urinary tract infections (UTIs) (p=0.0255). The risk of VTE was 4.5 times higher in those who had recently undergone surgery (p=0.0151). Analysis of the ROC showed 3.95 mg/L to be the appropriate D-dimer cutoff value for screening for VTE (area under the curve [AUC], 0.63; 95% confidence interval [CI], 0.5-0.8) in patients with acute or subacute brain lesions. This differs greatly from the conventional D-dimer cutoff value of 0.55 mg/L. D-dimer levels less than 3.95 mg/L in the absence of surgery showed a negative predictive value of 95.8% (95% CI, 78.8-99.8). CONCLUSION: Elevated D-dimer levels alone have some value in VTE diagnosis. However, the concomitant presence of UTI or a history of recent surgery significantly increased the risk of VTE in patients with acute or subacute brain lesions. Therefore, a different D-dimer cutoff value should be applied in these cases.
Brain Diseases ; Brain* ; Diagnosis ; Hemiplegia ; Humans ; Logistic Models ; Mass Screening ; Odds Ratio ; Pulmonary Embolism ; Retrospective Studies ; Risk Factors ; ROC Curve ; Urinary Tract Infections ; Venous Thromboembolism* ; Venous Thrombosis