Checkrein Deformity Due to Flexor Digitorum Longus Adhesion after Comminuted Calcaneus Fracture: A Case Report / 대한족부족관절학회지

The checkrein deformity describes tethering of the flexor hallucis longus tendon, which mainly occurs after fracture of the distal tibia. The deformity increases with dorsiflexion of the ankle and decreases or disappears with plantarflexion of the ankle. In some cases, the deformity may occasionally include the second and third toes. In the current study, the authors experienced secondary checkrein deformity of all lesser toes after open reduction and plate fixation for comminuted fracture of the calcaneus. As a treatment, plate and screws were removed, followed by an additional medial incision which showed a partially ruptured flexor digitorum longus tendon with severe adhesion. Resection of the adhesed tendon and tenodesis of its distal portion to the flexor hallucis longus was performed for correction of the checkrein deformity. Then the lessor toe checkrein deformity recovered immediately. The authors report on this rare lessor toe checkrein deformity after calcaneal fracture fixation with a review of literature.

Relationships among Depression, Self-rated Health, Health Behaviors and Drug Abuse by Job Status / 한국직업건강간호학회지

PURPOSE: This study was performed to investigate the present condition of drug abuse and its association with depression, self-rated health and health behaviors by job status in Korean adults. METHODS: Data were derived from the study on four addiction problem and suicide in 2014. Multiple logistic regression was used to analyze patterns of drug abuse according to depression, self-rated health and health behaviors. RESULTS: The prevalence of drug abuse during the past year was 17.1% of the 4,018 subjects. About 3.3 times risk for drug abuse was found among individuals who had high depression scores. The risk of drug abuse was higher among those who were smoking (OR:1.46, 95% CI:1.17~1.83), drinking more frequently (OR:1.30, 95% CI:1.07~1.58), sleeping insufficiently (OR:1.31, 95% CI:1.03~1.67), eating irregularly (OR:1.45, 95% CI:1.19~1.76). Drug abuse problem was detected more seriously among employed than unemployed adults. CONCLUSION: Health-related behaviors, such as smoking, drinking, sleeping, eating should be considered simultaneously when designing strategies to deal with drug abuse problem, and it is important to understand the interaction between drug abuse and mental health. Furthermore, workplace based intervention can be effective in solving drug abuse problem.

Tubal pregnancy with accessory fallopian tube: A case report / 대한산부인과학회지

Mullerian duct anomalies are reported in literature, but maldevelopment of fallopian tube in isolation is rare. Accessory fallopian tubes can present as infertility, ectopic pregnancy, in association with urinary tract anomalies. We observed a case of tubal pregnancy where fallopian tube has two fimbriae with normal looking uterine and fallopian tube on the opposite side. we report a case of tubal pregnancy with accessory fallopian tube with literature review.

Tubal pregnancy with accessory fallopian tube: A case report / 대한산부인과학회지

Mullerian duct anomalies are reported in literature, but maldevelopment of fallopian tube in isolation is rare. Accessory fallopian tubes can present as infertility, ectopic pregnancy, in association with urinary tract anomalies. We observed a case of tubal pregnancy where fallopian tube has two fimbriae with normal looking uterine and fallopian tube on the opposite side. we report a case of tubal pregnancy with accessory fallopian tube with literature review.

The Characteristics of Incidental Pituitary Microadenomas in 120 Korean Forensic Autopsy Cases

To investigate the characteristics of incidental pituitary microadenomas, we examined 120 pituitary glands from Korean forensic autopsy cases, from which eight tumors were identified (incidence 6.7%). The average age of the affected subjects was 50 yr (range: 33-96 yr) with a female predominance. The maximum diameters of the tumors ranged from 0.4 to 5.4 mm (mean: 2.8 mm). Immunohistochemical analysis of pituitary hormones revealed three growth hormone-secreting adenomas, one prolactin-producing adenoma, one gonadotropin-producing adenoma, one plurihormonal adenoma, and two null cell adenomas. MIB-1 staining for Ki-67 antigen showed no positive expression. The microvessel density (MVD) of the pituitary microadenomas ranged from 2.3 to 11.6% (mean: 5.3%) and was significantly lower than that of nonneoplastic pituitary glands (11.9-20.1%, mean: 14.8%). Our study provides reference data on incidental pituitary microadenomas in the Korean population.

A case of parovarian tumor of borderline malignancy / 부인종양

Parovarian cysts, generally known as hydatid cysts of Morgagni, are small round cysts attached by a pedicle to the fimbriated end of the tube. Due to the rarity of this lesion, there are controversies concerning the origin, clinical behavior, treatment and prognosis of these tumors. Parovarian borderline malignancy mostly occur in young women, main complaints are abdominal enlargement and pelvic pain. we experienced one case of parovarian borderline malignancy and report this case with a brief review of literature.

Diagnostic Availability of Ultrasonography and the Effects of Methotrexate Therapy in Patients with Eosinophilic Fasciitis: Report of Two Cases / 대한류마티스학회지

Eosinophilic fasciitis (EF) is a rare disorder of unknown etiology characterized by eosinophilia, indurations of the skin, and inflammation of the fascia. Magnetic resonance imaging (MRI) has been used to assist the diagnosis and to monitor the response to treatment, and the commonly used therapy has been corticosteroids. However, the use of ultrasonography (US) in the diagnosis and the management of EF has not been reported previously in Korea. In addition, the effects of methotrexate (MTX) treatment have rarely been reported in corticosteroid-resistant patients with EF. Here, we describe two cases of EF resistant to corticosteroid therapy alone where the combination of MTX and corticosteroids was effective. Furthermore, we show that US is useful modality in supporting the clinical diagnosis and monitoring the response to treatment of patients with EF.

A Case of Primary Signet Ring Cell Adenocarcinoma of the Uterine Cervix / 대한산부인과학회지

Signet ring cell adenocarcinoma of the cervix is most commonly considered to be metastatic in origin. We describe one case of primary signet ring cell adenocarcinoma of the cervix occuring in 49-year-old patient. The lesion was located at the posterior lip of the cervix and about 3 cm in size. This case was parametrium thickening in pelvic examination and positive for HPV type 18. CCRT (concurrent chemoradiotherapy) was done for clinical FIGO stage II B adenocarcinoma of the cervix. The patient is alive for 6month since diagnosis and disappear lesion of the cervix. A upper gastroenteroscopy, colonoscopy, cystoscopy, intravenous pyelogram, abdominal pelvic CT, PET CT, mammogram were reported negative. Therefore we concluded this case for a primary cervical origin of signet ring cell adenocarcinoma of the uterine cervix.

Comparison between Power Doppler Ultrasonography and Nailfold Capillaroscopy for the Differentiation of Raynaud's Phenomenon / 대한류마티스학회지

OBJECTIVE: To evaluate the usefulness of power Doppler ultrasonography (PDU) in diagnosing Raynaud's phenomenon (RP) and in differentiating primary RP from secondary RP comparing with nailfold capillaroscopy (NFC). METHODS: Microvascularity in the nailfold and finger tip of ten healthy controls and 36 patients with primary RP (n=16) or secondary RP (systemic sclerosis, n=20) was evaluated using PDU before and after cold challenge, respectively. Also, NFC was performed in all persons. The results of PDU were compared with the findings of NFC. RESULTS: According to the change of microvascularities before and after cold challenge, the findings of PDU are classified into 3 patterns such as normal, primary RP, and secondary RP. PDU yielded a correct classification in 87.5% of the persons analyzed (normal=100%, primary RP=87.5%, secondary RP=75%) and confirmed presence of RP in all patients with clinically diagnosed RP. There was good correlation between PDU and NFC examination for differentiating primary RP from secondary RP (Kappa=0.611, p<0.01). CONCLUSION: The PDU technique is a useful and reliable method to diagnose RP and to discriminate between primary RP and secondary RP and the results of PDU is well correlated with those of NFC examination.

A Statistical Analysis on Legal Autopsy in Chung-cheong Area of Korea in 2003: The Central District of National Institute of Scientific Investigation / 대한법의학회지

We reviewed forensic autopsies and scene examinations performed at Central District of National Institute of Scientific Investigation, requested by every kinds of law enforcement agencies in Chung-cheong area of Korea during the year of 2003, and analysed the data of forensic autopsies and scene examinations according to the cause of death and the manner of death. The results are as follows ; 1. Scene investigation on the spot was performed in 220 cases ; Among these cases, 161 cases (73.2%) were unnatural deaths and the most common cause of death was trauma (61 cases). Autopy was per-formed in 93 cases (42.3%). 2. The total number of forensic autopsy were 685 cases (452 males and 233 females). The number of the forties (215 cases) and the thirties (124 cases) occupied almost half (49.5%) of all cases of autopsy. 3. Unnatural deaths were 434 cases (63.3%), natural 204 cases (29.8%), and the unknown 47 cases (6.9%). In 434 cases of unnatural deaths, suicide was 84 cases (19.3%), homicide 115 cases (26.5%), acci-dent 186 cases (42.9%), and the undetermined 49 cases (11.3%). Homicide occupied 43.7% of trauma, 77.1% of blunt force injury excluding traffic and fall down injury, and 97.7% of sharp force injury. The homicide rate in asphyxia was 35.0%. It showed only 1 cases (1.9%) of homicide in poisoning. 4. In 434 cases of unnatural deaths, traumatic deaths were 229 cases (52.8%). Blunt trauma was 70 cases (30.6%) and the leading cause of death in traumatic death. Of remaining 205 cases of unnatural deaths, there were 52 cases (12.0%) of poisonings, 51 cases (11.8%) of thermal injuries, 41 cases (9.4%) of drowning, 40 cases (9.2%) of asphyxia, 19 cases (4.4%) of medical procedures, and 2 cases (0.5%) of electrocution. 5. Among 204 natural deaths, cardiovascular diseases were 106 cases (52.0%) and the leading cause of death in natural deaths. 36 cases (17.6%) of diseases involving vascular system were followed. 6. Child deaths under the age of 10 were 32 cases. Among these cases, unnatural deaths were 14 cases (43.8%) and most of them were accident.

Development of Customer Relationship Management System in the Healthcare Domain Using Data Mining / 대한의료정보학회지

OBJECTIVE: To provide medicare services for patients demands satisfyingly, immediate introduction of the Customer Relationship Management(CRM) is raised inevitable. In this paper we proposed that the minimizing the hospital losses by cut down the rate of cancelation of the hospital reservation, to secure patients as clients. METHODS: And to implement the data mining-based healthcare customer relationship management system applied from the back propagation algorithm of the artificial neural networks technique and the Feature GENeration(FGEN) algorithm of the decision tree technique. RESULTS: In this paper we divided a patient to an appropriate group through a data mining process and classified more correct customer through a campaign process. CONCLUSION: These results would be essential for new patients to enhance hospital reliability, for hospital to select profitable patients with high loyalty and to manage patients efficiently.

Comparison of Corneal Substitutes Using PLGA, Collagen, Collagen with Amniotic Membrane Homologous Cornea

PURPOSE: To evaluate the biocompatibility of the corneal substitutes using PLGA scaffold, type I collagen film, type I collagen film combined with amniotic membrane (AM) and lyophilized homologous cornea in severely damaged ocular surface disease. METHODS: Rabbits were distributed into four experimental groups: (1) Type 1 collagen film: group A, (2) Type I collagen film combined with AM: group B, (3) lyophilized homologous cornea: group C, and (4) PLGA scaffold: group D. Corneal substitute-like discs in 7 mm diameter were inserted into the intralamellar stromal pockets of severely damaged corneas, and then corneal windows in 3 mm diameter were made on the upper lamellar cornea in groups A, B, and C. In 2 months of follow up, clinical evaluation including corneal neovascularization, opacity and transparency of the graft materials was performed, and the inflammatory reaction and fibroplasia were evaluated histologically. RESULTS: Corneal windows were completely reepithelized by postoperative day 3 to 9, and more rapid reepithelization was shown in groups B and C, Corneal neovascularization, opacity, and inflammation decreased more in groups B and C. No inflammation and transparent graft material was shown in group C. Histological studies showed many corneal stromal fibroblasts in and around graft materials in groups B and C. CONCLUSIONS: The type I collagen film combined with AM and the lyophilized homologous cornea were more stable in the severely damaged cornea. These results could be useful for the development of corneal substitutes.

Review of Mechaincal Asphyxia of the Neck: Fatal Pressure on the Neck: The Central District of National Institute of Scientific Investigation / 대한법의학회지

Mechanical asphyxia of the neck(hanging, ligature strangulation, manual strangulation and combined deaths) provides one of the most complex and controversial areas of 'asphyxial' deaths. To better understand the presentation of such cases, we reviewed retrospectively forensic autopsy files of the Central District Office, National Institute of Scientific Investigation from June 1, 2000, through June 31, 2003 for all such cases. A total of 80 cases were found; hanging 37 cases(46.3%), ligature strangulation 9 cases(11.2%), manual strangulation 25 cases(31.3%) and combined deaths 9 cases(11.2%). Economic problem was one of most frequent motives. Petechiae were present in the conjunctivae and/or sclerae in 37.5% of hanging cases, 100.0% of ligature strangulation cases, 88.8% of manual strangulation cases and 88.9% of combined deaths cases; fractures of the hyoid and/or thyroid cartilage were most frequently present in manual strangulation(52.0%). All children under 10 years old were killed by their parents. Fifty-nine percent of the victims had been subjected to additional violence. Twenty-six percent of victims had blood alcohol.

A Case of Alveolar Soft Part Sarcoma in the Orbit Diagnosed as C avernous Hemangioma befo re Operation

Alveolar soft part sarcoma is a very rare malignant neoplasm which originates from the soft tissue. The common site is lower extremity and it is especially rare to occur primarily in the orbit. It is characterized that tumor shows organoid arrangement of lobules separated by numerous delicate vascular septa and individual tumor cell contained PAS positive crystalline granules in the cytoplasm. Moreover, because of hypervascular tumor, it is easy to misdiagnosed as a cavernous hemangioma which commonly occurs in the orbit. We experienced a 29-year-old male who had suffered from unilateral proptosis.Before operation, ultrasonography, MRI and single photon emission computed tomography (SPECT) were performed and we suspected that the retro-orbital mass was a cavernous hemangioma. Using Kr onlein method,lateral orbitotomy was performed and large well encapsulated tumor mass (2.5 x2.5 x2.0 cm)was excised. On histopathological examination the tumor was confirmed as an alveolar soft part sarcoma. Therefore, we report this interesting case with review of the literature.

Percutaneous Cholecystostomy for Gallbladder Perforation: Early Response and Final Outcome in 10 Patients

PURPOSE: To evaluate the efficacy of percutaneous cholecystostomy (PC) as a therapeutic maneuver for patientswith spontaneous gallbladder (GB) perforation. MATERIAL AND METHODS: Ten patients with acute cholecystitis andsuspected GB perforation underwent emergency PC; perforation was documented by means of ultrasound, computedtomography, and/or fluoroscopy. All patients but two had a variety of high risk factors for open cholecystectomy:diabetes mellitus (n=2), cardiac disease (n=2), acute renal failure (n=1), liver cirrhosis (n=1), overwhelmingsepsis (n=1), and age over 80 (n=1). All percutaneous cholecystostomies were performed with ultrasound guidanceand preferably via the transhepatic route. A favorable response to PC was defined as an improvement in clinicalsymptoms and signs or reduction in fever, and return of the WBC to normal within 72 hr of the procedure. RESULTS:All procedures were technically successful, and no major procedure-related complications occurred. Eight patients(80%) responded favorably to PC. One, who did not respond, underwent emergency cholecystectomy next day due toworsening peritonitis, and the other who failed to respond within 72 hr showed delayed response after drainage ofa coexistent liver abscess at seven days after the procedure. A patient who responded to PC experienced catheterdislodgement four days after the procedure but reinsertion was not required. Five of eight patients who respondedpositively underwent elective cholecystectomy after the improvement of clinical symptoms, and the three remainingpatients improved without further surgery. CONCLUSION: For the treatment of patients in whom GB perforation issuspected, PC is a safe and effective alternative to surgical cholecystectomy.

Comparison of Na, K between arterial whole blood and venous serum electrolyte analyzer: For clinical use of arterial whole blood analysis of electrolytes

BACKGROUND: Recently, there are so many newly developed equipments to detect blood gas analysis with serum electrolytes. And then, so many important parameters are quickly reported from laboratory department. So, many clinicians use the data to manage the critical patient. We attempted to detemine the correlation coefficient and adjustment equation. METHODS: Total 68 patients results of Na, K that are cheked using arterial whole blood(288 blood gas system) and venous serum electrolytes analyzer(NOVA 6) were evaluated and we detemined the coefficient of two methods from April to September, 1995. RESULTS: The correlations between the results obtained with NOVA 6 and that of 288 blood gas system were excellent for both Sodium and potassium(r>0.95, p<0.001 in both). In this study, we make the regression equation to adjust the differences between the two methods. Na : y=1.004190X+7.656643(r=0.9637, p<0.001) y=venous serum Na, x=arterial whole blood Na K: y=0.994831X+0.489631(r=0.9545, p<0.001) y=venous serum K, x=arterial whole blood K. CONCLUSIONS: Specimen(whole blood, serum), kind and content of heparin also affect the results of electrolytes. And then, the report of the result after adjustment of them using above equation will provide reinforcement of the efficacy of the results using arterial whole blood specmen. We recommend it especially for emergency laboratories for critical test.

Prevalence of Silent Otitis Media with effusion in Preschool Children in Kunsan city

BACKGROUND: Otitis media with effusion(OME) is a very common disease in pediatric age. However, a few literatures on epidemiologic study of otitis media with effusion are available in Korea due to the great variability of its diagnostic criteria and clinical features. The aim of this study is to provide the estimate of silent otitis media prevalence for preschool age. METHODS: The study population includes 329 children enrolled in 6 kindergartens in Kunsan city from April 1 to 10, 1995. Silent otitis media was diagnosed with otoscopy, pneumatic otoscopy and impedance audiometry by DANAC 40 model impedance audiometer from DANA JAPAN Co. RESULTS: The prevalence of silent otitis media with effusion was 14.5% and peak at 6 years of age(17.8%).The prevalence of silent otitis media with effusion according to sex were 11.8% in boys group, 17.9% in girls group. Nine cases(11.8%) involved bilaterally. Forty three cases(89.6 %) were asymptomatic cases. CONCLUSIONS: Among 329 preschool children, the prevalence of silent otitis media with effusion was 14.5%. The prevalence by sex showed slightly higher in girls group than boys group. OME involved unilateral site mostly and subjective symptoms were rare.

Evaluation of family function in the inpatient of rehabilitation medicine department witn impairment of activity of daily living

BACKGROUND: When one of family members must be treated, the others are required to get various forms of changes including modification of their proper roles in the family. Particularily when he or she can not perform his or her activities of daily living(ADL) owing to functional impairment by himself or herself, there seems to be greater dependence upon his or her family. Accordingly, we tried to give help in the treatment of patients through the comparative analysis concerning functional impairment in both groups on the assumption that there is difference of family function between two family groups which have a patient in family, or not. METHODS: This study was carried out to 83 inpatients in Sun Hospital in Dae Jeon and local rehabilitation clinics in Iksan from 1. July. 1995 to 31. Jun. 1996. We evaluated activites of daily living by using modified Barthel Index(MBI) and classified them into dependent group with 60 points or less(6roup I ), and independent group with more than 60 points(Group II). We also used Family APGAR score and FACES III to evaluate their family functions. RESULTS: MBI scores to evaluate ADL were 42.9+/-15.6 in Group I and 82.1+/-17.9 in Group II. Family APGAR scores were 6.93+/-2.52 in Group I and 7.24+/-17.9 in Group II but there was no significance between two groups. Types of family according to Family APGAR score were highly functional, morderate dysfunctional, and severly dysfunctional one in order of frequency in both groups, but there was no significance in their frequencies in both groups. Types of Family in view of cohesion was disengaged, separated, connected, and enmeshed one in order of frequency in Group I, and separated, disengaged, connected, and enmeshed one in order of frequency in Group II but there was no significance between two groups. Types of family in view of adaptability were rigid, chaotic structured,and flexible one in order of frequency in Group I, and were flexible, structured, rigid, and chaotic one in orders in Group II, which showed significance between two groups. Extremal types of family structure were large in numbers in Group I, but it didnt show significance. CONCLUSIONS: Assuming that there were large numbers of rigid and chaotic family in Group I, it is considered that tne family which has a patient with severely impaired function seems to have weaker adaptability to their family stresses than otherwise. Therefore, it is desirable that physicians who take charge of such patients provide continuous and comprehensive medical care for them including their family with greater concerns and through analysis and assessment of their family functions.

Two Cases of Small Cell Carcinoma of the Ovary / 대한부인종양콜포스코피학회잡지

Small cell carcinoma of the ovary is a rare, distinctive, highly malignant, and undifferenciated carcinoma of unknown cullular lineage. It tends to occur in young women, and there is an associated paraneoplastic hypercalcemia in as many as two-thirds of reported cases. It has very poor prognosis and has been exceedingly difficult to treat. Thus a proven regimen of adjuvant therapy is not defined yet. We report here the two cases of primary small cell carcinoma of the ovary, which is presented with a brief review of the literature.

Pulmonary Arteriovenous Malformation Treatment with Detachable Balloon: A Case Report

Pulmonary arteriovenous malformation(PAVM) are associated with substantial risks if left untreated. The literature reports a 40-50% incidence of paradoxical embolization. Percutaneous arterial embolization has become the standard treatemtn for PAVM. We report a case of pulmonary arteriovenous malformation successfully treated bytranscatheter embolization using detachable balloons and we also demonstrate long-term follow up CT findings.