Scapholunate advanced collapse (SLAC) deformity most often occurs with chronic rotary scaphoid instability from scaphoiunate ligament tear and scaphoid fracture. Prior to 1984 when Watson HK reported his concept on SLAC wrist deformity, the most popular procedure for this pathology was scaphoid implant arthroplasty with or without midcarpal fusion. We have reviewed 15 cases of SLAC deformity treated with scaphoid excision and midcarpal fusion from 1984 to 1993. Among them, scaphoid implants made of silicone were inserted in 4 cases. Scaphoid implant arthroplsty without carpal fusion has been excluded. The mean period of follow-up was 8.8 years and the mean age of patients was 47.5 years. Males and right wrists were predominant. Wrist motion was 56% and grip power was 71% of the normal opposite side. On the average overall, 8 patients had no pain and 7 patients had mild pain. The grade of pain was minimal, 0.5 in grade (Rating system: no pain-0, mild- 1, moderate-2, severe-3). However, all of the 4 cases of limited carpal fusion with a scaphoid implant developed silicone particulate induced synovitis and pain. The procedure appears to be effective in maintaining function of the hand with minimal pain up to 5.8 years. However, silicone scaphoid implant appears not to be necessary and is not recommended with a limited carpal fusion for this pathology.
Arthroplasty ; Congenital Abnormalities ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Ligaments ; Male ; Pathology ; Silicones ; Synovitis ; Wrist

No abstract available.
Lasers, Dye* ; Melanosis*

A clinicopathological study was made on 17 case with leukemia cutis diagnosed in a period of 10 years frorn 1980 to 1989 in Seoul Xational University I-lospital. The results were summarized as follows : 1. There were 4 cases with acute lyrnphocytic leukernia, 7 with acute myelocytir. leukemia (AML), 5 with chronic myelocytic leukemia (CML), 1 with eosinophilic leukemia. 2. The clinical appearance of leukemia cutis included nodules (88.2%), papules, macules, plaques and ulcerative lesions. Leukemia cutis dis not show any discernible clinical qppearance with each different type of leukemia. 3. Leukemia cutis showed a wide spectrum of histopathologic features, diffuse infiltration, patchy infiltration with linear infiltration between collagen bundles, perivascular and peridnexal involvement, perivascular involvement, and mainly subcutaneous tissue involvement. There was no distinctive histopathologic pattern with each different type of leukemia. 4. The demonstration of intracytoplasmic chloroacetate esterase and lysozyme was helpful to refine the diagnosis of leukemia cutis.
Collagen ; Diagnosis ; Hypereosinophilic Syndrome ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Muramidase ; Seoul ; Subcutaneous Tissue ; Ulcer

Spinal cord infarction, especially anterior spinal artery syndrome, is a relatively rare disease. We report a case of spinal cord infarction caused by thoracoabdominal aortic aneurysm with intraluminal thrombus. A 52-year-old man presented with sudden onset paraplegia. At first, he was diagnosed with cervical myelopathy due to a C6-7 herniated intervertebral disc, and had an operation for C6-7 discetomy and anterior interbody fusion. Approximately 1 month after the operation, he was transferred to the department of rehabilitation in our hospital. Thoracoabdominal aortic aneurysm with intraluminal thrombus was found incidentally on an enhanced computed tomography scan, and high signal intensities were detected at the anterior horns of gray matter from the T8 to cauda equina level on T2-weighted magnetic resonance imaging. There was no evidence of aortic rupture, dissection, or complete occlusion of the aorta. We diagnosed his case as a spinal cord infarction caused by thoracoabdominal aortic aneurysm with intraluminal thrombus.
Animals ; Anterior Spinal Artery Syndrome ; Aorta ; Aortic Aneurysm ; Aortic Aneurysm, Thoracic ; Aortic Rupture ; Cauda Equina ; Horns ; Humans ; Infarction ; Intervertebral Disc ; Magnetic Resonance Imaging ; Middle Aged ; Paraplegia ; Rare Diseases ; Spinal Cord ; Spinal Cord Diseases ; Thrombosis

PURPOSE: To estimate the arrival-to-patient contact delays when accessing patients in high-rise buildings and evacuating them to the hospital, compared with accessing patients in ground-level premises. METHODS: This was a prospective study carried out, between 20 and 31 October, and between 30 November and 7 December, 2008, on emergency calls received at the Bun-dang fire station. The first thirty-five consecutive cases were enrolled in two groups where appropriate: evacuations in high-rise buildings, and evacuations in ground-level premises, respectively. Cases of road traffic accidents and road calls were excluded because they did not entail crew entering into buildings. The times were clocked using a stopwatch by an emergency medicine resident riding with the paramedics. We set forth to determine whether the intervals, recorded in the high-rise group, between: 1) time when the ambulance arrived at the scene and time of arrival at the patient's side; 2) time of leaving the premises with the patient and time when the ambulance starts its journey to the hospital, would differ significantly from that recorded in the ground-level group. RESULTS: 35 runs were analyzed in each group. The median value from arrival to patient contact was 0.34 minutes for the ground-level group compared with 2.08 minutes for the high-rise group (95% CI: p=0.000). The median value from the time of leaving the building with the patient to the time when the ambulance turned its engine on to start its journey to the hospital were 1.00 minutes and 3.08 minutes for the ground-level and high-rise groups, respectively (95% CI: p = 0.000). CONCLUSION: There were significant delays when accessing and evacuating patients in high-rise buildings. We suggest modifications to buildings and elevators to help minimize these delays.
Accidents, Traffic ; Allied Health Personnel ; Ambulances ; Elevators and Escalators ; Emergencies ; Emergency Medical Services ; Emergency Medicine ; Fires ; Humans ; Korea ; Prospective Studies ; Reaction Time

We report a case of a 44-year-old patient with paralysis of the left leg who had a thoracic epidural catheterization after general anesthesia for abdominal surgery. Sensory losses below T10 and motor weakness of the left leg occurred after the surgery. Magnetic resonance image study demonstrated a well-defined intramedullary linear high signal intensity lesion on T2-weighted image and low-signal intensity on T1-weighted image in the spinal cord between T9 and L1 vertebral level, and enhancements of the spinal cord below T8 vertebra and in the cauda equina. Electrodiagnostic examination revealed lumbosacral polyradiculopathy affecting nerve roots below L4 level on left side. We suggest that the intrinsic spinal cord lesion and nerve root lesion can be caused by an epidural catheterization with subsequent local anesthetic injection.
Analgesia, Epidural ; Anesthesia, General ; Catheterization ; Catheters ; Cauda Equina ; Humans ; Leg ; Magnetic Resonance Spectroscopy ; Paralysis ; Polyradiculopathy ; Spinal Cord ; Spinal Cord Injuries ; Spine

OBJECTIVE: The aim of this study is to assess the relationships between maternal plasma and umbilical cord leptin concentrations and their effects on newborn birth weights, maternal body mass indices and fetal sex in term normotensive (NT) and preeclampsia (PE) women. METHODS: Blood samples were obtained at delivery from 20 NT group and another 20 from PE group of at least 36 weeks of gestation. And the umbilical cord samples were also taken from their newborns at birth. Plasma leptin levels were determined in both groups using a human recombinant leptin 125-I radioimmunoassay. RESULTS: Mean maternal plasma and umbilical cord leptin concentrations were 16.16+/-2.05 ng/ml and 7.11+/-1.01 ng/ml in NT group, 17.09+/-1.67 ng/ml and 8.55+/-6.63 ng/ml in PE group, and there was no statistical significances among them. The differences of leptin concentrations in maternal plasma and umbilical cord according to baby sex were not significant in both NT and PE groups. Plasma leptin concentrations were related with maternal weight gain and BMI in NT group and with body weight in PE group. The BMI and birth weights of the neonates have significant effects on the umbilical cord leptin concentrations in both NT and PE groups. CONCLUSION: In this study, no correlation was found between maternal plasma and umbilical cord leptin concentrations in both NT and PE groups. But maternal plasma leptin concentrations had positive correlations with maternal body weight, BMI, and body weight changes during pregnancy in both NT and PE groups. There were also positive correlations among umbilical cord leptin concentrations, BMI and birth weights of the neonates of NT and PE groups term. Therefore umbilical cord leptin is considered to be the index of fetal birth weight.
Birth Weight ; Body Weight ; Body Weight Changes ; Female ; Fetal Blood* ; Fetal Weight* ; Humans ; Infant, Newborn ; Leptin* ; Parturition ; Plasma* ; Pre-Eclampsia* ; Pregnancy ; Radioimmunoassay ; Umbilical Cord ; Weight Gain

OBJECTIVE: The aim of this study is to assess the relationships between maternal plasma and umbilical cord leptin concentrations and their effects on newborn birth weights, maternal body mass indices and fetal sex in term normotensive (NT) and preeclampsia (PE) women. METHODS: Blood samples were obtained at delivery from 20 NT group and another 20 from PE group of at least 36 weeks of gestation. And the umbilical cord samples were also taken from their newborns at birth. Plasma leptin levels were determined in both groups using a human recombinant leptin 125-I radioimmunoassay. RESULTS: Mean maternal plasma and umbilical cord leptin concentrations were 16.16+/-2.05 ng/ml and 7.11+/-1.01 ng/ml in NT group, 17.09+/-1.67 ng/ml and 8.55+/-6.63 ng/ml in PE group, and there was no statistical significances among them. The differences of leptin concentrations in maternal plasma and umbilical cord according to baby sex were not significant in both NT and PE groups. Plasma leptin concentrations were related with maternal weight gain and BMI in NT group and with body weight in PE group. The BMI and birth weights of the neonates have significant effects on the umbilical cord leptin concentrations in both NT and PE groups. CONCLUSION: In this study, no correlation was found between maternal plasma and umbilical cord leptin concentrations in both NT and PE groups. But maternal plasma leptin concentrations had positive correlations with maternal body weight, BMI, and body weight changes during pregnancy in both NT and PE groups. There were also positive correlations among umbilical cord leptin concentrations, BMI and birth weights of the neonates of NT and PE groups term. Therefore umbilical cord leptin is considered to be the index of fetal birth weight.
Birth Weight ; Body Weight ; Body Weight Changes ; Female ; Fetal Blood* ; Fetal Weight* ; Humans ; Infant, Newborn ; Leptin* ; Parturition ; Plasma* ; Pre-Eclampsia* ; Pregnancy ; Radioimmunoassay ; Umbilical Cord ; Weight Gain

BACKGROUND: Umbilical cord (UC) is a promising source of mesenchymal stromal cells (MSCs). We compared the characteristics of MSCs from cryopreserved UC with those from fresh tissues, and demonstrated the possibility of UC cryopreservation for acquisition of MSCs from cryopreserved UC. METHODS: Each UC was sliced into two types (1~2 mm3 vs. 0.5 cm), and cryopreserved in liquid nitrogen using different media (autologous cord blood plasma, aCBP vs. RPMI 1640). A fresh aliquot of 1~2 mm3-sized UC was used as control tissue. After one week, the cryopreserved tissues were thawed and cultured. For the 0.5 cm UC, a slicing step into 1~2 mm3 was needed. Cell count, viability, proliferative activity, and surface antigens were determined from harvested MSCs. Several growth factors (EGF, IGF-1, PDGF, TGF-beta, bFGF, and VEGF), were measured from the culture supernatant. RESULTS: Eleven UC were enrolled in the study. Efficiencies of obtaining MSCs were higher in cryopreserved UC using RPMI 1640, compared with use of aCBP; the same result was observed for 0.5 cm sized UC, compared with 1~2 mm3 sized UC. No difference in proliferative activity was observed between MSCs from fresh and cryopreserved UC. The amount of growth factors in culture supernatant using RPMI 1640 was larger than that of fresh tissues. CONCLUSION: We obtained growth factors from the supernatant as well as MSCs from cryopreserved UC. As with a cord blood bank, in the future, cryopreservation of UC for acquisition of both MSCs and growth factors would be possible in a time of need.
Antigens, Surface ; Cell Count ; Cryopreservation ; Fetal Blood ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins ; Mesenchymal Stromal Cells ; Nitrogen ; Plasma ; Transforming Growth Factor beta ; Umbilical Cord