There were few studies about anatomic characteristics in Korean humerus recently. In addition, there was no comparison between Westerner (European and American) and Korean in anatomic characteristics of humerus. The aims of this paper are therefore to investigate anatomic characteristics in Korean humerus and to compare them with those of Westerner humerus. The seventy-two humerus (male : 66, female : 6) were scanned by computed tomography and three dimensional (3D) models of humerus were then reconstructed from acquired cross-section images. The twenty-one anatomic characteristics of the humerus were analyzed and were measured for each humerus. From the results, humeral head vertical diameter in the present study was generally bigger than that in the previous study (p<0.05). There was no significant difference between the anatomic characteristics of the right and left humerus in the present Korean (p>0.05). Humeral head inclination angle, greater tuberosity lateral offset distance, humeral head height in Korean were generally bigger than those in Westerner (p<0.05). This study may contribute to develop an optimal implants and prostheses for the treatment of humerus fractures of Koran.
Female ; Humans ; Humeral Head ; Humerus ; Prostheses and Implants

The effects of Rh incompatibility in bone marrow transplantation (BMT) has not been studied extensively as ABO incompatibility. But it has been known that Rh incompatibility does not impair the engraftment of donor bone marrow. The recipient's blood groups were AB, DCe, who has anti-E and anti-c in her serum. The sibling donor blood groups were B, DCEce. There was a minor ABO incompatibility and Rh incompatibility due to anti-E and anti-c between donor and recipient. We performed the plasma and RBC depletion of marrow using the cell separator before it was infused. The clinical course after BMT was not eventful except mild delayed hemolysis and delayed hematopoietic recovery, which may be attributable to low marrow cell dose.
Antibodies* ; Blood Group Antigens ; Bone Marrow Transplantation* ; Bone Marrow* ; Hemolysis ; Humans ; Plasma ; Siblings ; Tissue Donors

PURPOSE: The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is a validated scoring system for auditing surgical outcomes. However, evaluation of this system has primarily been applied to open surgical techniques. The present study demonstrates the validity of P-POSSUM in predicting morbidity and mortality in the treatment of elderly patients with gastric cancer who underwent curative laparoscopic gastrectomy. METHODS: All patients aged 70 years or over, who underwent curative laparoscopic gastrectomy between January 2014 and January 2015, were collected from our hospital database. A case-note review was used to collate data in terms of clinical and operative factors as described in P-POSSUM. Observed/Estimated ratio of morbidity and 30-day mortality were calculated. RESULTS: Laparoscopic gastrectomy was performed in 101 patients. The mean age was 74.9 years (70~83 years). A significant postoperative morbidity was observed in 20 (19.8%) of 101 patients. There was no 30-day mortality. Using exponential analysis, P-POSSUM predicted morbidity in 22 patients. Thus, O/E ratios for morbidity and mortality were 0.9 and 0, respectively. CONCLUSION: P-POSSUM scoring slightly overestimated predictions of morbidity and mortality. An assessment of its application to laparoscopic gastrectomy of elderly patients with gastric cancer merits further evaluation. Also, laparoscopic gastrectomy was a feasible and safe treatment for elderly patients in terms of P-POSSUM.
Aged* ; Gastrectomy* ; Humans ; Mortality ; Stomach ; Stomach Neoplasms*

OBJECTIVES: To quantitate apoptosis and Fas antigen expression of T lymphocytes by activation in aplastic anemia (AA) and compare with that of normal controls and completely-recovered AA, and to investigate the apoptotic sensitivity to anti-fas antibody of activated T lymphocytes in AA. METHODS: We studied the expression of Fas antigen on fresh T lymphocytes of twenty patients with AA [13 newly diagnosed, 7 recorvered AA after immunosuppressive therapy (IST)], and investigated the activation-induced cell death (AICD) and Fas expression by activation [interleukin-2 (200 U/ml) and phytohemagglutinin (50 micrograms/ml)] in 5 newly-diagnosed AA, 5 normal controls and 5 AA in complete response (CR). Apoptotic sensitivity to anti-Fas antibody was assessed by the time-course kinetics of induction of cell death by anti-Fas antibody (500 ng/ml). RESULTS: There was no significant difference of Fas antigen expression on freshly-isolated T lymphocytes among newly-diagnosed severe AA, normal control s and patients with AA in CR after IST. In normal controls, T lymphocytes death was greatly increased at 3 days of activation, and Fas antigen expression on T lymphocytes was increased above baseline at day 1 of activation. In contrast, in newly-diagnosed AA, T lymphocytes showed delayed cell death, which correlated with a slowed increase of Fas antigen expression by activation. Also, anti-Fa s antibody sensitivity of activated T lymphocytes was decreased in newly-diagnosed AA. In completely recovered AA, these abnormal AICD and Fas antigen expressions by activation were recovered to normal range. CONCLUSIONS: Abnormal AICD plays a role in the immune pathophysiology of AA, and defective Fas system is involved in this process.
Anemia, Aplastic/pathology ; Anemia, Aplastic/immunology* ; Antigens, CD95/blood ; Apoptosis ; Case-Control Studies ; Human ; In Vitro ; Lymphocyte Transformation ; T-Lymphocytes/pathology* ; T-Lymphocytes/immunology* ; Time Factors

Aspergillus causes a variety of clinical syndromes in the lung including tracheobronchial aspergillosis, invasive aspergillosis, chronic necrotizing pulmonary aspergillosis, allergic bronchopulmonary aspergillosis, and aspergilloma. Aspergilloma usually results from ingrowths of colonized Aspergillus in damaged bronchial tree, pulmonary cyst or cavities of patients with underlying lung diseases. There are a few reports on endobronchial aspergilloma without underlying pulmonary lesion. We have experienced a case of endobronchial aspergilloma associated with foreign body developed in an immunocompetent patient without underlying lung diseases. A 59-year-old man is being hospitalized with recurring hemoptysis for 5 months. X-ray and computed tomography scans of chest showed a nodular opacity in superior segment of left lower lobe. Fiberoptic bronchoscopy revealed an irregular, mass-like, brownish material which totally obstructed the sub-segmental bronchus and a foreign body in superior segmental bronchus of the lower left lobe. Histopathologic examinations of biopsy specimen revealed fungal hyphae, characteristic of Aspergillus species.
Aspergillosis ; Aspergillosis, Allergic Bronchopulmonary ; Aspergillus ; Biopsy ; Bronchi ; Bronchoscopy ; Colon ; Foreign Bodies ; Hemoptysis ; Humans ; Hyphae ; Immunocompetence ; Invasive Pulmonary Aspergillosis ; Lung ; Lung Diseases ; Thorax

The expression of the WT-1 gene which is found exclusively in human leukemic blasts frequently disappears from bone marrow of leukemia patients in complete remission (CR). Using semiquantitative RT-PCR, we investigated the expression of the WT-1 gene in peripheral bloods (PBs) of 33 patients with acute leukemia (AML 26; ALL 7) and monitored its expression after achievement of CR. None of the 6 normal controls expressed detectable levels of WT-1 transcripts (< 10(-4), background level), whereas 31 (93.9%) of 33 patients expressed variable levels of WT-1 transcripts (range, 10(-4) to 10(1)) at diagnosis. The level of WT-1 expression was not different between AML and ALL. By monitoring WT-1 gene expression in PB of 31 patients during CR, 5 patients relapsed (two from the 18 patients with undetectable levels of WT-1 gene expression and three from the 13 with WT-1 gene expression in low levels). Three of the 5 relapsed patients showed preceding reappearance or rise of WT-1 gene expression. From these results, we reconfirmed that the WT-1 gene is a pan-acute leukemic marker, which can be used to monitor minimal residual leukemia (MRL) after chemotherapy or in patients with CR.
Gene Expression/physiology* ; Human ; Leukemia, Lymphocytic, Acute/genetics* ; Leukemia, Lymphocytic, Acute/blood* ; Leukemia, Myelocytic, Acute/genetics* ; Leukemia, Myelocytic, Acute/blood* ; Neoplasm, Residual ; Nephroblastoma/genetics* ; Polymerase Chain Reaction ; Transcription, Genetic ; Tumor Markers, Biological

We present a case of a 52-year-old woman with iatrogenic stent deformation occurred after deployment of the left main (LM) stent due to the unintentional undermining of the proximal part of the LM stent with subsequent balloon dilatation. We tried to crush the deformed part of the LM stent against the left coronary cusp by pushing it with a guiding catheter. The deformed stent was stabilized after stent crushing and the patient didn't have any cardiovascular events. This case highlights that stent deformation could be successfully managed by crushing the deformed part of the stent to the coronary sinus.
Catheters ; Coronary Angiography ; Coronary Sinus ; Coronary Vessels* ; Dilatation ; Female ; Humans ; Middle Aged ; Multidetector Computed Tomography ; Stents*

Primary lymphoma presenting in the thyroid gland is uncommon. A review of the Yonsei University Medical Center experience between 1982 and 1994 was performed retrospectively to assess the treatment outcome and prognostic factors. There were four females and one male, and the median age was 65 years. All 5 cases presented with a neck mass. Two of them had co-existing biopsy-proved Hashimoto's thyroiditis and three cases were each in a hypothyroid state. All cases with non-Hodgkin's disease were of intermediate grade. One case was in stage IE and four were in stage IIE. Three cases were treated with surgery alone and two cases with bulky inoperable stage IIB were treated with chemo-radiotherapy. Chemotherapy induced a complete response in one and a partial response in the other with minimal transient toxicity. As the questions regarding justification for extensive surgical intervention increase, combined chemo-radiotherapy can be suggested as an initial treatment even in stage I, and stage II thyroid lymphoma based on prognostic factor evaluation.
Aged ; Biopsy, Needle ; Combined Modality Therapy ; Female ; Human ; Lymphoma/*diagnosis/pathology/*therapy ; Male ; Middle Age ; Neoplasm Staging ; Thyroid Neoplasms/*diagnosis/pathology/*therapy ; Treatment Outcome

Invasive aspergillosis is an infection that occurs in immunocompromised patients. Its prevalence was increased in the last decade with progression of antineoplastic chemotherapy and immunosuppressive therapy after transplantation. Because it carries a high mortality and morbidity, early diagnosis and aggressive treatment are critical for successful management. In many patients, invasive aspergillosis remains confined to the lung although direct extension to pleural cavity or pericardium has been reported. However great vessel involvement is rare. Therefore we report a case of invasive aspergillosis involving right subclavian artery and chest wall in a patient after chemotherapy for acute lympoblastic leukemia.
Aspergillosis ; Drug Therapy ; Early Diagnosis ; Humans ; Immunocompromised Host ; Invasive Pulmonary Aspergillosis* ; Leukemia ; Lung ; Mortality ; Pericardium ; Pleural Cavity ; Prevalence ; Subclavian Artery* ; Thoracic Wall* ; Thorax*

BACKGROUND: There has been much evidence that immune-mediated stem cell injury may have a significant role in the pathogenesis of aplastic anemia, and as a result immunosuppressive therapy has become known as an effective treatment for patients with aplastic anemia. There have been no reports regarding the long-term follow-up of immunosuppressive therapy of patients with aplastic anemia in Korea. Therefore, we evaluated the response to immunosuppressive therapy for 47 patients with aplastic anemia, investigating the long-term survival, relapse rate and secondary clonal hematologic diseases. METHODS: Antithymocyte globulin (ATG) or antilymphocyte globulin (ALG) was given with cyclosporin A (CsA) to 39 patients (ATG+CsA 27, ALG+CsA 12), and to 8 patients, ATG or ALG alone was given (ATG 6, ALG 2). ATG was administered for 5 (or 8) days, and ALG was administered for 5 days. CsA was orally begun with ATG or ALG for a median total of 4.5 (3~14) months. RESULTS: 1) Response: Among 47 patients, 30 (63.8%) responded; 11 showed complete response (CR) and 19 showed partial response (PR). 2) Factors affecting response: Responses were equally distributed when patients were stratified for age, neutrophil counts and drug regimens. 3) Survival: Median duration of follow-up was 36 (6~84) months. Actuarial survival at 1 year was 100% in responders and 76% in nonresponders, and the 7-year actuarial survival rate was 94% and 76%, respectively (P value = 0.13). 4) Relapse: Relapse occurred in 4 of 30 responding patients. Relapse in patients with CR was not observed during follow-up. The risk of relapse was 12% at 2 years and 22% at 6 years. 5) Treatment outcome according to disease duration: There was no significant difference in response rate between patients treated within 4 months and beyond 4 months after diagnosis. But the latter group showed a significantly higher relapse rate than the former (4% vs 60%; P value = 0.01). 6) Side effects and complications: There were no serious side effects requiring discontinuation of immunosuppressive therapy. Evolution to secondary clonal hematologic diseases was not observed during follow-up. CONCLUSION: Our results of immunosuppressive therapy show the excellent long-term outcome. A prospective study is needed for the establishment of the adequate treatment duration of CsA and the follow-up period for the evaluation of the response of treatment.
Anemia, Aplastic* ; Antilymphocyte Serum ; Cyclosporine ; Diagnosis ; Follow-Up Studies ; Hematologic Diseases ; Humans ; Korea ; Neutrophils ; Recurrence ; Stem Cells ; Survival Rate ; Treatment Outcome*