No abstract available.
Holoprosencephaly*

No abstract available.
Anemia, Aplastic* ; Hepatitis*

The stress fracture is a disease which results from the application of an abnormal stress to the normal bone by the action of the constant and repeated muscular pull. Stress fracture has been reported in the long bones of the lower extremities and in the pelvis, however, of recent days, it is reported in the long bones of the upper extremities. In the past, stress fractures were seen mainly in military personnel. However, in recent years, a significant number of stress fractures have been seen in sports due to the great popularization of sports. 48 cases of stress fractures in 43 patients who have been diagnosed and treated at the Department of Orthopedic Surgery of National Police Hospital, from Jan. 1984 to Jan. 1986, were analysed. The following results were obtained: l. Occurrence ratio by sex, there were more male patients than female(M:F=2: 1). Age distribution was various from 14 to 9, but we could see high frequency occurred in the teenage. 2. The order of occupational distribution was as follows; Athletes were extremely high, 25 (58. 1%), combat policeman, 16(37.2%) and others, 2(4.7%). 3. Most of the stress fractures were in the tibia, an incidence of 57.3%. 4. The period from the beginning of exercise to the occurence of the stress fracture varies from 6 days to 2 years. 4. Although initial X-ray film results being negative, we think that it necessary to check bone scan and follow-up X-ray study.
Age Distribution ; Athletes ; Clinical Study ; Follow-Up Studies ; Fractures, Stress ; Humans ; Incidence ; Lower Extremity ; Male ; Military Personnel ; Orthopedics ; Pelvis ; Police ; Sports ; Tibia ; Upper Extremity ; X-Ray Film

Dislocations of the toes are comparatively rare. The majority of the these injuries occur in the great toe at the metatarsophalangeal joint. Dislocations of the interphalangeal joint of the great toes are extremely unusual, especially interphalangeal dislocation of the grcat toe with interposition of a sesamoid bone is extremely rare. Authors wishes to report two cases of interphalangeal dislocation of the great toe with interposition of the interphalangeal sesamoid.
Dislocations ; Joints ; Metatarsophalangeal Joint ; Sesamoid Bones ; Toes

Background: This study is a 1-year follow-up study for mentally disabled people who started living independently. The purpose of this study is to confirm the performance of the supported independent housing (SIH) program for severe mental illness and to compare the effectiveness with the collective living family, a group home (GH). Methods: This study included mentally disabled people living in publicly supported SIH (n=24) and living in GH (n=31). The outcome measures were brief psychiatric rating scale, Global Assessment Function (GAF), internalized stigma, hope, self-esteem, life satisfaction, and working alliance. Analyzes were performed using descriptive methods and chi-square analysis, Independent t-test, Mann-Whitney U-test, and Friedman test. Results: In the case of the SIH group, GAF and internalized stigma showed a significant effect after 1 year, and the working alliance showed a tendency to decrease at 6 months and then increase again after 1 year. In comparison between the two groups, only GAF showed a significant difference after 1 year. Hope, self-esteem, and life satisfaction showed a significant effect in the GH group after 1 year, but not in the SIH group. Conclusions Results show that the SIH and GH housing types achieve different results over the 1-year period. GAF and internalized stigma were significant in SIH, and psychological variables were significant in GH. In GAF, SIH showed a more significant effect than GH. Housing support should take into account the various individual circumstances and preferences of the client, and above all, securing housing stability and expanding accessibility is important.

BACKGROUND: The present study estimated healthcare costs of osteoporotic fractures including spine, hip, distal radius and humerus in Koreans over 50 years of age using national claims data. METHODS: Korea National Health Insurance data between 2008 and 2011 was searched for all claims records of outpatient visits or hospital admissions of patients ≥50-year-of-age. Osteoporosis-related fractures were identified using certain the International Classification of Diseases, Tenth Revision codes and site-specific physician claims for procedures in a patient age cut-off value of 50 years. The healthcare costs included acute phase costs accounting for emergency medical care given immediately after fracture, costs due to further hospitalization and surgical procedures, physiotherapy sessions according to the site of the fracture, and outpatient visits in the year after discharge. RESULTS: The total estimated healthcare costs of osteoporotic fractures in 2011 was $722 million. From 2008 to 2011, the total number and healthcare costs of osteoporotic fractures increased 28.9% (from 127,070 to 163,823) and 31.6% (from $549 million to $722 million), respectively. The portion of national health care expenditure was ranged from 2.3% in 2008 to 2.2% in 2011. The mean healthcare cost of osteoporotic fractures per person increased 2.1% from $4,321 in 2008 to $4,410 in 2011.The mean healthcare costs were highest for hip fractures followed by spine, humerus, and distal radius fractures. CONCLUSIONS: Total Healthcare costs of osteoporotic fractures in South Koreans ≥50-year-of-age increased between 2008 and 2011. This trend will likely continue, which is an important health problem in the elderly population and economically.
Aged ; Delivery of Health Care* ; Emergencies ; Health Care Costs* ; Health Expenditures ; Hip ; Hip Fractures ; Hospitalization ; Humans ; Humerus ; International Classification of Diseases ; Korea* ; National Health Programs* ; Osteoporotic Fractures* ; Outpatients ; Radius ; Radius Fractures ; Spine

BACKGROUND: Neointimal hyperplasia and thrombosis are the major factors responsible for vascular access occlusion. Previous studies suggested that the renin-angiotensin system has been implicated in the pathogenesis of neointimal hyperplasia and thrombosis. Recent studies have shown that angiotensin-converting enzyme (ACE) gene polymorphism may have a association with venous thrombosis. We conducted a retrospective case control study to determine the influence of ACE gene polymorphism on the progression of radiocephalic wrist arteriovenous fistulae (RCAVF). Also, we investigated the association between ACE polymorphism and various thrombotic factors in thrombosed and nonthrombosed subjects. METHODS: 56 patients (24 males and 32 females, mean age 49.8, age range 12-81) whose RCAVF had been maintained in good condition after 2 months of vascular access operation were included in this study. Lipoprotein (a), total cholesterol, C-reactive protein (CRP) and homocystein were measured before hemodialysis session in fasting state. Clinical data such as body mass index (BMI), cigarette smoking, hypertension, and diabetes were retrieved from patient's records. The ACE genotype was analyzed by the polymerase chain reaction (PCR). RESULTS: The incidence of diabetes and cigarette smoking were similar in the three genotypes. There were no significant differences in BMI, total cholesterol, lipoprotein (a), CRP and homocystein (p=0.551, 0.429, 0.279, 0.392, 0.124, respectively) among DD, ID and II genotypes. The percentage of the DD, ID and II genotypes were 16%, 43%, 41%, respectively. Compared with the ID and II genotypes, the proportion of the thrombosed AV shunts was larger in DD genotypes. But there was no statistically significant difference between ACE polymorphism and RCAVF thrombosis (x2=1.027, df=2, p=0.598). ACE polymorphism is shown to have no association with body mass index, blood level of total cholesterol, lipoprotein (a), CRP and homocystein. CONCLUSION: These results suggest that ACE polymorphism may have some influences on the vascular access occlusion in maintenance hemodialysis patients and have no relationship with body mass index, total cholesterol, lipoprotein (a), CRP and homocystein.
Arteriovenous Fistula* ; Body Mass Index ; C-Reactive Protein ; Case-Control Studies ; Cholesterol ; Fasting ; Female ; Genotype ; Humans ; Hyperplasia ; Hypertension ; Incidence ; Lipoprotein(a) ; Male ; Polymerase Chain Reaction ; Renal Dialysis* ; Renin-Angiotensin System ; Retrospective Studies ; Smoking ; Thrombosis ; Venous Thrombosis ; Wrist

PURPOSE: To report a case of rapidly progressed orbital abscess after central retinal artery occlusion. CASE SUMMARY: A 60-year-old man with right periorbital pain and edema starting 3 days earlier visited the hospital. His first visual acuity was 1.0 for the right eye with peripheral edema and tenderness; severe hemorrhagic chemosis, proptosis (approximately 3 mm) and extraocular motility limitation were also observed. According to the CT findings, a 2.5 x 1 cm-sized encapsulated cystic mass was found in the right orbital cavity, along the medial orbital wall; with a diagnosis of orbital abscess, he was hospitalized with systemic antibiotic treatment and abscess drainage. On the second day of hospitalization, the best corrected visual acuity was reduced to light perception, and relative afferent pupillary defect, pale retina and cherry red spot were found. Therefore, emergent incisional drainage, optic massage, and antibiotics were given to the patient. Immediately after the surgery, the peripheral edema and proptosis improved; nevertheless, central retinal artery occlusion did not resolve and vision did not improve. Two months later, best corrected visual acuity for the right eye was counting fingers and central retinal artery occlusion showed no further improvement. CONCLUSIONS: No case report on rapidly progressing orbital abscess has been proposed in Korea to date. In the case of rapidly progressed orbital abscess, incisional drainage and antibiotics should be administered promptly.
Abscess ; Anti-Bacterial Agents ; Drainage ; Edema ; Exophthalmos ; Eye ; Fingers ; Hospitalization ; Humans ; Korea ; Light ; Massage ; Middle Aged ; Orbit ; Prunus ; Pupil Disorders ; Retina ; Retinal Artery ; Retinal Artery Occlusion ; Vision, Ocular ; Visual Acuity

Purpose: To analyze the repeatability of manual measurement of foveal avascular zone (FAZ) area in an optical coherence tomography angiography (OCTA) image in high myopia. Methods: This study comprised patients with high myopia and controls. Two consecutive FAZ areas of the superficial and deep capillary plexus were obtained using OCTA. The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were assessed, and univariate and multivariate generalized linear mixed models were conducted to identify factors related to repeatability. Results: Thirty eyes with high myopia and 34 eyes of healthy subjects were included in the study. The mean age in high myopia and control subjects was 55.5 and 60.8 years, respectively, the mean spherical equivalent was −9.98 and −0.55 diopters, and the mean axial length was 28.0 and 23.9 mm. The ICCs of FAZ area of the superficial capillary plexus (SCP) were 0.891 and 0.919, while the CVs were 8.8% and 8.5%. In measurement of the deep capillary plexus, the ICCs were 0.788 and 0.907, while the CVs were 11.2% and 11.0%, which were acceptable but exhibited lower repeatability than those of SCP. Multivariate analyses showed that older age (p = 0.030) and greater axial length (p = 0.005) were significantly associated with lower repeatability of SCP FAZ area measurements. In addition, greater axial length (p = 0.044) was a significant factor for lower repeatability of deep capillary plexus FAZ area measurements. Conclusions Manual measurement of FAZ area using OCTA exhibited relatively good repeatability for high myopia. Age and axial length affected repeatability and should be considered when analyzing FAZ areas in high myopia patients.