Three cases of Dupuytrens contracture which developed in hands were reported along with review of literatures. Partial fasciectomy was done as the choice of treatment for them to improve impairment of function of the hands. No attributable causes for the developement of the disease were found.
Dupuytren Contracture ; Hand

PURPOSE: To study prognostic factors of unilateral calcaneus fracture underwent surgery. MATERIALS AND METHODS: We selected appropriate 60 cases of 236 calcaneus fracture cases between March 1985 and March 2004, and analyzed the correlation between sex, age, smoking, injury mechanism, Essex-Lopresti classification of calcaneus fracture, preoperative Bohler angle, postoperative Bohler angle, postoperative 1 year Bohler angle and Visual Analogue Scale (VAS), P.S. Kerr's Calcaneal Fracture Score (CFSS). The average age was 41.4 and average follow up period was 74 (12 to 240) months. RESULTS: For follow up period, average VAS is 3.43 and CFSS is 81.23. The sex, age, smoking, injury mechanism, and preoperative, postoperative, postoperative 1 year Bohler angle had no correlation with the prognosis. But the Essex-Lopresti classification of calcaneus fracture, tongue type had better prognosis than joint depression type (VAS : p=0.041, CFSS : p=0.021). CONCLUSION: In unilateral calcaneus fracture, the sex, age, smoking, injury mechanism, preoperative Bohler angle, postoperative Bohler angle, postoperative 1 year Bohler angle had no correlation with the prognosis of fracture, but in Essex-Lopresti classification, the tongue type fracture had better prognosis than the joint depression type.
Calcaneus ; Classification ; Depression ; Follow-Up Studies ; Joints ; Prognosis ; Smoke ; Smoking ; Tongue

This experimental studies was to investigate the location of PNS and CNS labeled neurons following injection of 2% WGA-HRP and pseudorabies virus (PRV), beta-galactosidase inserted Bartha strain, into the epididymis of rats. After survival times 4~5 days following injection of 2% WGA-HRP and PRV-Ba-Gal, the rats were perfused, and their brain, spinal cord, sympathetic ganglia and spinal ganglia were frozen sectioned (30 mm). These sections were stained by HRP histochemical and beta-galactosidase histochemical staining methods, and observed with light microscope. The results were as follows : 1. The WGA-HRP labeled sympathetic ganglia projecting to the epididymis were observed in pelvic ganglion and L1-6 lumbar sympathetic ganglia. 2. The WGA-HRP labeled spinal ganglia projecting to the epididymis were observed in L1-6 spinal ganglia. 3. The beta-galactosidase labeled neurons projecting to the epididymis were observed in lamina VII of cervical segments. In thoracic segments, beta-galactosidase labeled neurons were observed in dorsomedial part of lamina I, II and III. Dense labeled neurons were observed in intermediolateral n. and dorsal commissural n.. In lumbar segment, labeled neurons were observed in lamina III, IV, V, dorsal commisural n. and superficial dorsal horn. 4. In the medulla oblongata, beta-galactosidase labeled neurons projecting to the epididymis were observed in the trigeminal spinal n., A1 noradrenalin cells/C1 adrenalin cells/caudoventrolateral reticular n., rostroventrolateral reticular n., area postrema, n. tractus solitarius, raphe obscurus n., raphe pallidus n., raphe magnus n., parapyra-midal n., lateral reticular n. and lateral paragigantocellular reticular n.. 5. In the pons, labeled neurons were observed in Kolliker-Fuse n., locus coeruleus, subcoeruleus n. and A5 noradrenalin cells. 6. In midbrain, labeled neurons were observed in periaqueductal gray substance, retrorubral n., substantia nigra and dorsal raphe n.. 7. In the diencephalon, labeled neurons were observed in paraventricular hypothalamic n., lateral hypothalamic nucleus., medial preoptic n. and retrochiasmatic n.. These results suggest that WGA-HRP labeled neurons of the spinal cord projecting to the rat epididymis might be the first-order neurons related to the viscero-somatic sensory and sympathetic postganglionic neurons, and beta-galactosidase labeled neurons of the brain and spinal cord may be the second and third-order neurons response to the movement of vascular smooth muscle in epididymis. These beta-galactosidase labeled neurons may be central autonomic center related to the integration and modulation of reflex control linked to the sensory and motor system monitoring the internal environment. These observations provide evidence for previously unknown projections from epididymis to spinal cord and brain which may be play an important neuroanatomical basic evidence in the regulation of epididymal function.
Animals ; Area Postrema ; beta-Galactosidase ; Brain ; Diencephalon ; Epididymis* ; Ganglia, Spinal ; Ganglia, Sympathetic ; Ganglion Cysts ; Herpesvirus 1, Suid* ; Horns ; Hypothalamic Area, Lateral ; Locus Coeruleus ; Male ; Medulla Oblongata ; Mesencephalon ; Muscle, Smooth, Vascular ; Neural Pathways* ; Neurons ; Periaqueductal Gray ; Pons ; Pseudorabies* ; Rats* ; Reflex ; Spinal Cord ; Substantia Nigra ; Wheat Germ Agglutinin-Horseradish Peroxidase Conjugate*

No abstract available.
Drinking Behavior* ; Drinking* ; Humans

To describe two cases of thoracic paraplegia due to a thoracic spinal cord tumor (meningioma) that was not detected during lumbar spinal decompressive surgery for lumbar canal stenosis and a complaint of claudication. The follow-up period ranged from 1 year and 6 months to 1 year and 8 months. The neurological deficit due to thoracic meningioma after surgery for lumbar canal stensois was decreased after mass excision. So, careful physical examination and magnetic resonance imaging can reveal another thoracic spine compressive lesion such as meningioma. Additional thoracic decompressive surgery can provide partial amelioration of each patient's neurological condition. Surgeons should know that a silent meningioma can aggrevate neurological symptoms after lower lumbar spine surgery and should inform their patient before surgery.
Constriction, Pathologic ; Follow-Up Studies ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Meningioma ; Paraplegia ; Physical Examination ; Spinal Cord Neoplasms ; Spine

Background: Hydroxyethyl starch (HES, 6% 130/0.4) has been used as a volume expander for the treatment of cerebral hypoperfusion in acute ischemic stroke. Although HES use was associated with renal failure in sepsis or critical illness, it still remains to be elucidated whether HES is linked to renal adverse events in patients with acute ischemic stroke. Methods: A total of 524 patients with acute ischemic stroke within 7 days of onset were included between January 2012 and May 2016. Renal function on admission and follow-up on day 7 ± 2 was assessed using serum creatinine (SCr) and estimated glomerular filtration rate (eGFR). Propensity score matching (PSM) was used to perform a 1:1 matched-pair analysis to minimize the group differences caused by covariates. The percentage of patients with newonset acute renal injury (AKI) using the Kidney Disease: Improving Global Outcomes or good functional outcome (modified Rankin Scale 0–2) at 90 days were compared between HES cohort and controls. Results: Among the included patients (mean age, 68.6 years; male, 56.5%), 81 patients (15.5%) were HES cohort (median cumulative dose, 1,450 mL). Baseline renal function was better in HES cohort compared to that in the controls (SCr, 0.87 ± 0.43 mg/dL vs. 1.15 ± 1.15 mg/dL, P < 0.001; eGFR, 86.91 ± 24.27 mL/min vs. 74.55 ± 29.58 mL/min, P < 0.001), which became not significant in PSM cohort (72 pairs). The percentage of new-onset AKI did not differ between the HES cohort and controls (1.4% vs. 1.4%, P = 1.000). In addition, newonset AKI was not related to HES (odds ratio, 1.422; 95% confidence interval, 0.072–28.068; P = 0.817) after adjusting for confounders. HES cohort tended to have higher percentage of good functional outcome at 90 days compared to controls, which failed to reach statistical significance (68.1% vs. 54.2%, P = 0.087). Conclusion A low cumulative dose of HES was not associated with renal adverse events in patients with acute ischemic stroke.

OBJECTIVES: Single-pill combination therapy (amlodipine/atorvastatin) might be more effective than double-pill therapy (amlodipine+atorvastatin) in patients with diabetes and concomitant hypertension requiring statin therapy. We compared the cost-effectiveness of a single-pill with that of double-pill for control of low density lipoprotein cholesterol (LDL-C) levels, with the ultimate goal of cardiovascular disease prevention, in these patients using a cost-effectiveness analysis model that considered medication adherence. METHODS: Effectiveness was defined as the percentage (%) attainment of target LDL-C levels (<100 mg/dL) based on adherence for each therapy. Adherence was defined as compliance to medication (> or =80% proportion of days covered). A systematic review of the literature was conducted to determine the proportion of patients who were adherent and target goal attainment based on adherence level. The annual medication costs were based on the adherence levels for each regimen. The average cost-effectiveness ratio (ACER) was calculated as the cost per % attainment of the target LDL-C level. RESULTS: The ACER for the single-pill regimen was lower than for the double-pill regimen (4,123 vs. 6,062 Korean won per 1% achievement of target goal). Compared with the double-pill, the medication costs were approximately 32% lower with the single-pill. CONCLUSION: A single-pill for reductions in LDL-C is cost-effective compared with double-pill in hypertensive patients with type 2 diabetes.
Acer ; Amlodipine ; Cardiovascular Diseases ; Cholesterol, LDL ; Compliance ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypertension ; Korea* ; Lipoproteins* ; Medication Adherence ; Atorvastatin Calcium

No abstract available.
Fetus* ; Humans ; Male* ; Mesothelioma*

Malignant transformation of mature cystic teratoma is rare and difficult to diagnose preoperatively. Therefore, in the suspected case considering the age, tumor size and imaging findings, it is important to diagnose intraoperatively through a frozen section biopsy. It is clear that aggressive optimal surgical resection should be done in the squamous cell carcinoma arising from mature cystic teratoma. However it is controversy what postoperative adjuvant therapy is optimal in the locally advanced case because of its rarity. We report a case of a 59-year-old woman in the menopause with locally advanced squamous cell carcinoma arising from left ovarian mature cystic teratoma treated with optimal cytoreductive surgery followed by concurrent chemoradiation.
Biopsy ; Carcinoma, Squamous Cell ; Female ; Frozen Sections ; Humans ; Menopause ; Middle Aged ; Teratoma

Malignant transformation of mature cystic teratoma is rare and difficult to diagnose preoperatively. Therefore, in the suspected case considering the age, tumor size and imaging findings, it is important to diagnose intraoperatively through a frozen section biopsy. It is clear that aggressive optimal surgical resection should be done in the squamous cell carcinoma arising from mature cystic teratoma. However it is controversy what postoperative adjuvant therapy is optimal in the locally advanced case because of its rarity. We report a case of a 59-year-old woman in the menopause with locally advanced squamous cell carcinoma arising from left ovarian mature cystic teratoma treated with optimal cytoreductive surgery followed by concurrent chemoradiation.
Biopsy ; Carcinoma, Squamous Cell ; Female ; Frozen Sections ; Humans ; Menopause ; Middle Aged ; Teratoma