The most common site of posterior urethral valve is that in which there is an exaggeration of the normal ridges which extend from the midline dorsal urethral ridge and from the verumontanum to surround the urethra just before the membranous region. Obstruction to urine flow may be complete or partial. In patients with partial obstruction, failure to thrive, systemic acidosis with renal failure and continuous over-flow dribbling rather than a good urinary stream may be seen. Apart from the problem of renal damage consequent to the obstruction, these children are subject to recurrent urinary infections. Excretory urography and retrograde cystourethrography are needed to establish the diagnosis. The characteristic proximal ballooning of the urethra is best seen during micturition or attempts to express urine from the bladder. Early surgical decompression is warranted. A temporary diversionary procedure is recommended, with a definitive operation at a later age to correct the valvular obstruction. We experienced a case of posterior urethral valve which was developed in a 4 years old boy, treated this case by destruction of posterior urethral valve and report it with brief review of literatures.
Acidosis ; Child ; Child, Preschool ; Decompression, Surgical ; Diagnosis ; Failure to Thrive ; Humans ; Male ; Renal Insufficiency ; Rivers ; Urethra ; Urinary Bladder ; Urination ; Urography

Metaplastic carcinoma is a rare form of breast carcinoma in which a variety of metaplastic changes occur. These commonly involve squamous or spindle cells, but pure chondroid metaplasia is relatively uncommon. We report a case of metaplastic carcinoma of the breast which mainly involved chondroid metaplasia and in which chondroid calcifications were seen on mammograms.
Breast Neoplasms ; Breast* ; Cartilage ; Metaplasia

Langerhans cell histiocytosis (LCH), previously called histiocytosis X, refers to a spectrum of disease characterized by idiopathic proliferation of histiocytes producing focal or systemic manifestations. Causes and pathogenesis remain unclear. The basic histopatholgic findings are identical in the three well-established clinical syndromes (eosinophilic granuloma, Hand-Shuller-Christian disease, Letterer-Siwe disease). The disease has a predilection for children, although it may occur in adults. We experienced two cases of adult onset Langerhans cell histiocytosis in the ribs. One case was associated with diabetes insipidus and the other case had a solitary lesion.
Adult* ; Child ; Diabetes Insipidus ; Granuloma ; Histiocytes ; Histiocytosis ; Histiocytosis, Langerhans-Cell* ; Humans ; Ribs*

PURPOSE: To evaluate the clinical outcome after the over-the-top augmentation with ABC synthetic lig-ament for the treatment of acute rupture of anterior cruciate ligament at least two years follow up. MATERIALS AND METHODS: From January 1992, authors have treated acute rupture of ACL with this method on 91 cases. Among these, 46 cases were available for full data acquisition. At the last follow-up, clinical results were analyzed subjectively and objectively by Lachman, pivot shift test and presence of joint effusion. Functional evaluation was performed by various knee ligament scoring systems and the side-to-side differences were measured with KT-2000 arthrometer. RESULTS: On Lachman test, 82.7% were under grade Iⅈ grade 0 : 17 cases(37%), grade I: 21 cases(45.7%), grade III: 8 cases(17.3%). 89.3% were under grade 0 & Ion pivot shift test. On measure-ment of side-to-side difference, 25 cases(54.3%) were showed difference less than 3 mmand the differences of 16 cases(34.8%) were 3~5 mm. On six cases joint effusions were present. Among these six cases, four cases were accompanied by anterior instability which were brought to second look arthroscopy. Two cases were treated with several times of aspiration and steroid instillation. The one case was failed its continuity which solved with ACL reconstruction with patellar bone-tendon-bone autograft. The other three cases showed only lax ACL which was cared with retightening of ligament at the femoral attach-ment site. At the last follow up, 37 cases(80.4%) were resulted excellent and good on Lysholm score and 41 cases(89.1%) were group A & B on IKDC score. On Tegner scale, 34 cases(73.9%) were above five point. CONCLUSIONS: Authors suggest this over-the-top augmentation of ACL with synthetic polyester ligament would be good treatment option with several advantages; early rehabilitation is possible to get maximal function of knee and no tunnel in the lateral condyle would be good for late ACL reconstruction even though failure of this artificial ligament.
Anterior Cruciate Ligament* ; Arthroscopy ; Autografts ; Follow-Up Studies ; Joints ; Knee ; Ligaments* ; Polyesters ; Rehabilitation ; Rupture*

BACKGROUND: Malignant middle cerebral artery (MCA) infarction is one of the leading cause of death for patients with acute MCA infarction. We investigated the predicting factors for developing malignant MCA infarction (MMI) using multi-parametric magnetic resonance imaging (MRI). METHODS: We included 159 MCA infarction patients who visited Dong-A University Stroke Center from January 2007 to December 2010 and were diagnosed MCA occlusion within 6 hours after symptom onset. All patients underwent brain MRI including diffusion and perfusion-weighted image. The definition of the malignant MCA infarction is as follows: 1) deterioration of neurological symptoms and consciousness with clinical signs of uncal herniation, and 2) at least two-thirds of the MCA territory with compression of ventricles or midline shifting. The neurological deterioration was observed for 7 days. The severity of neurological symptom and clinical outcome were assessed by using National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). RESULTS: Among 159 patients, 49 patients (30.8%) developed MMI. In a multivariate analysis, a larger diffusion volume on diffusion-weighted image, a lower regional cerebral blood volume (rCBV) ratio on perfusion-weighted image, and a higher NIHSS score on admission were identified as the predictive factors of MMI. The cut-off values of diffusion volume, NIHSS on admission and rCBV ratio were 69 mL, 15 points and 0.78. CONCLUSION: A large diffusion volume, a high NIHSS score and particularly a low rCBV ratio can predict a malignant course in MCA infarction within 6 hours of symptom onset in MCA occlusion.
Blood Volume ; Brain ; Cause of Death ; Consciousness ; Diffusion ; Humans ; Infarction ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Multivariate Analysis ; National Institutes of Health (U.S.) ; Stroke

The congenital nasal piriform aperture stenosis (CNPAS) is a rare cause of neonatal airway obstruction and could be easily mistaken as the choanal stenosis or atresia. The piriform aperture is a term used to refer to the anterior nasal openings. The nasal airway obstruction in the neonate can result in respiratory difficulties and may be going to life threatening consequences. Computed tomography demonstrates in detail the underlying anatomic abnormalities which allows differentiation of the CNPAS from other upper airway abnormalities. We reported a case of CNPAS, a 1-month-old male infant presented with respiratory difficulties. Shortly after birth, he had mild respiratory difficulties and there was difficulty passing a nasal catheter intranasally. But he was improved through only conservative management and discharged at the age of 5 days. At the age of 1 month, CT scan revealed bilateral CNPAS.
Airway Obstruction ; Catheters ; Constriction, Pathologic* ; Humans ; Infant ; Infant, Newborn ; Male ; Nasal Obstruction ; Parturition ; Tomography, X-Ray Computed

PURPOSE: Diallyl disulfide (DADS), an organosulfur compound in garlic, has been reported to be effective in inhibiting the growth of several human tumor cell lines. The aim of this study was to determine whether DADS induced growth inhibition in MCF-7 breast cancer cell lines and to understand the molecular mechanism by which DADS acts. METHODS: MCF-7 cell lines were incubated with various concentrations of DADS for various time intervals and the cytotoxicity was determined by MTT assay. We examined the changes of intracellular proteins related to apoptosis, such as bcl-2, bax and PARP in cells treated with DADS. To study the expression level of bcl-2 and bax, which serve as modulators of apoptosis, we performed RT-PCR and western blot analysis. RESULTS: MCF-7 cells treated with DADS led to the suppression of viability and proliferation in both a time and concentration dependent manner. Microscopic observation revealed typical features of apoptosis in the DADS-treated cells, further verified in nuclear DAPI staining. Flow cyto-metry analysis with FITC-annexinV and propidium iodide (PI) demonstrated that the apoptotic cell population with AnnexinV+/PI- increased dramatically from ~0.8% to ~75% after 24h exposure to 500 microM DADS in MCF-7 cells. Cell cycle analysis demonstrated that the number of apoptotic cells increased with the increasing time of the DADS treatment. Additionally, thermore, we investigated the effects of DADS on apoptosis related gene expression in MCF-7 cells. PARP cleavage was markedly increased in the DADS treated cells with time. This result indicated that DADS induced the caspase-dependent apoptotic pathway. We also found down-regulation of bcl-2, however no significant change of Bax expression was observed after DADS treatment. Conclusion: Taken together, these results indicate that DADS induces apoptosis by activating a caspase pathway involving the activation of Bcl-2 but not of Bax. Our findings suggest chemotherapeutic potentials of DADS in human breast cancer.
Apoptosis ; Blotting, Western ; Breast Neoplasms* ; Breast* ; Cell Cycle ; Cell Line* ; Cell Line, Tumor ; Down-Regulation ; Garlic* ; Gene Expression ; Humans* ; MCF-7 Cells ; Propidium

PURPOSE: The purpose of this study is to compare the antibacterial activity of currently purchasable denture cleansers against Candida albicans. Materials and methods: This study used tablet-type denture cleansers, PolidentⓇ , CoolingdentⓇ and FittydentⓇ , along with liquid denture cleansers, HexamedineⓇ , ListerineⓇ and Apple vinegarⓇ . The antibacterial activities of denture cleansers were evaluated based on the number of C. albicans and concentrations of the denture cleansers. Results: In the 0.5 × 106 cfu/㎖ culture medium, the C. albicans’ death rate of PolidentⓇ was significantly lower than those of FittydentⓇ , HexamedineⓇ , ListerineⓇ , and Apple vinegarⓇ (P <.05). In the 0.5 × 107 cfu/, the C. albicans’ death rates of PolidentⓇ and CoolingdentⓇ were significantly lower than those of FittydentⓇ , HexamedineⓇ , ListerineⓇ and Apple vinegarⓇ (P <.05). The C. albicans’ death rates of PolidentⓇ and CoolingdentⓇ were significantly decreased at 0.02 g and 0.01 g. The C. albicans’ death rate of FittydentⓇ was significantly decreased at 0.005 g (P <.05). The C. albicans’ death rate of HexamedineⓇ was significantly decreased at 1/16 dilution. The C. albicans’ death rate of ListerineⓇ was decreased at 1/8 dilution, and the antibacterial activity of Apple vinegarⓇ was decreased at 1/4 dilution (P<.05). Conclusion As the number of C. albicans increased, the antibacterial activities of the denture cleansers decrease. In the tablet-type denture cleanser, all denture cleansers showed 100% C. albicans’ death rate when used at a dose of 1 tablet. One denture cleanser showed the same antibacterial effect with only 1/3 of a tablet. In the liquid type denture cleanser, the level of dilution required was different for each denture cleanser.

PURPOSE: The purpose of this study is to compare the antibacterial activity of currently purchasable denture cleansers against Candida albicans. Materials and methods: This study used tablet-type denture cleansers, PolidentⓇ , CoolingdentⓇ and FittydentⓇ , along with liquid denture cleansers, HexamedineⓇ , ListerineⓇ and Apple vinegarⓇ . The antibacterial activities of denture cleansers were evaluated based on the number of C. albicans and concentrations of the denture cleansers. Results: In the 0.5 × 106 cfu/㎖ culture medium, the C. albicans’ death rate of PolidentⓇ was significantly lower than those of FittydentⓇ , HexamedineⓇ , ListerineⓇ , and Apple vinegarⓇ (P <.05). In the 0.5 × 107 cfu/, the C. albicans’ death rates of PolidentⓇ and CoolingdentⓇ were significantly lower than those of FittydentⓇ , HexamedineⓇ , ListerineⓇ and Apple vinegarⓇ (P <.05). The C. albicans’ death rates of PolidentⓇ and CoolingdentⓇ were significantly decreased at 0.02 g and 0.01 g. The C. albicans’ death rate of FittydentⓇ was significantly decreased at 0.005 g (P <.05). The C. albicans’ death rate of HexamedineⓇ was significantly decreased at 1/16 dilution. The C. albicans’ death rate of ListerineⓇ was decreased at 1/8 dilution, and the antibacterial activity of Apple vinegarⓇ was decreased at 1/4 dilution (P<.05). Conclusion As the number of C. albicans increased, the antibacterial activities of the denture cleansers decrease. In the tablet-type denture cleanser, all denture cleansers showed 100% C. albicans’ death rate when used at a dose of 1 tablet. One denture cleanser showed the same antibacterial effect with only 1/3 of a tablet. In the liquid type denture cleanser, the level of dilution required was different for each denture cleanser.

OBJECTIVE: We attempted to discover that Ankylosing spondylitis (AS) has a comprehensive relationship with congestive heart failure and death.METHODS: We used a nationwide database managed by the Korean National Health Insurance Service from 2010 to 2014. Twelve thousand nine hundred eighty-eight patients with a diagnosis of AS and 64940 age- and sex- stratified matching subjects without AS were enrolled in the AS and control groups. Incidence probabilities of 6 years congestive heart failure and death in each group were calculated. The Cox proportional hazard regression analysis was used to estimate the hazard ratio. We divided the AS and control groups into subgroups according to sex, age, income, and comorbidities.RESULTS: During the follow-up period, 102 patients (0.79%) in the AS group and 201 patients (0.32%) in the control group developed congestive heart failure (p < ;0.0001). In addition, 211 (1.62%) subjects in the AS group died during the follow-up period compared to 639 (0.98%) subjects in the control group (p < ;0.0001). The adjusted hazard ratio of congestive heart failure and death in the AS group was 2.28 (95% confidence interval [CI], 1.80–2.89) and 1.66 (95% CI, 1.42–1.95), respectively. The hazard ratios of congestive heart failure and death were significantly increased in all of the subgroups.CONCLUSION: The incidence rates of congestive heart failure and death were increased in AS patients.
Cardiovascular Diseases ; Cohort Studies ; Comorbidity ; Diagnosis ; Epidemiology ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Heart Failure ; Humans ; Incidence ; Korea ; National Health Programs ; Spondylitis, Ankylosing