Primary pyogenic psoas abscess is rare lesion, and often is not suspected. Reasons for delayed diagnosis are unfamility with the lesion and the fact that symptoms often resemble those of primary disease of the hip. We present a case of primary pyogenic psoas abscess in child, which was diagnosed by MRI, and completely recovered after surgical treatment.
Child ; Delayed Diagnosis ; Hip ; Humans ; Magnetic Resonance Imaging ; Psoas Abscess

Fracture healing in the hand is not an isolated goal. The functional end result is of paramount importance. When the correct techniques are used, miniplate fixation for metacarpal and phalangeal fractures of the hand provides rigid internal fixation, stabilizes the skeleton, preserves the gliding tissue, and therefore allowing immediate active range of motion exercise as well as minimizing joint and tendon complications. The authors have reviewed 39 patients, 52 cases of metacarpal and phalangeal fractures of the hand which were treated with miniplate in the department of orthopaedic surgery, Chang Ang Gil hospital from Sep. 1989 to Feb. 1993. The following results were obtained. 1. Miniplate fixation, in terms of fracture reduction and maintenance, allows on accurate anatomic reduction with rigid fixation which in turn affords on early mobilization without loss of reduction alignment. 2. The roentgenographic union was obtained within 15.1 weeks in average. The mean total acitve motion at the fractured finger was 230°. The complication rate was 11.5%. 3. In the treatment of metacarpal and phalangeal fractures of the hand, especially fractures of metacarpal bones, fixation with miniplate is considered to be an useful method in terms of getting fracture union and good range of motion with relative low complication rates.
Early Ambulation ; Fingers ; Fracture Healing ; Hand ; Humans ; Joints ; Metacarpal Bones ; Methods ; Range of Motion, Articular ; Skeleton ; Tendons

Recently, intramedullary nailing has been used classically in a closed transverse fracture in middle one-third of the fernur. But difficult femorsl fracture, such as severe comminution or nonunion, present a much more difficult problem. To treat these difficult femur fractures effectively, several investigators have developed and implemented a interlocking nail. Huckstep nail, one of the variants of the inter-locking nail, is a solid four sided intramedullary nail with screw fixation device and titanium alloy. For the purpose of rigid fixation and compression, screw fixation the nail and both cortice has been used in the difficult femorsl fractures. The author have experienced the 19 cases of Huckstep nailing for the treatment of difficult femoral fracture at the Choongahng Gil Hospital from Jan., 1984 to Dec., 1987. The results are summarized as follows. 1) In the difficult femoral fractures, such as fracture on severe comminuted fracture, nonunion and metal failure etc, Huckstep nailing may be excellent fixation. 2) Open comrninuted femoral frsctures were treated by conservative treatment as antibiotic therapy and skeletal traction, but when general conditions return to normal and risk of infection rate minimized, Huckstep nailing should be done. This generally requires 4 to 6 weeks. 3) The mean duration of bone union was 21.2 weeks. 4) Early joint mobilization can be done. The results of 17 cases were excellent by Denker's criteria. 5) Important complication were metal failure with refracture, screw failure and refracture after extraction of nail, these were caused by incorrect placement of nail, incorrect length of nail and more rapidly early weight bearing. 6) Nail of 11.5 mm in diameter is suitable in our study.
Alloys ; Femoral Fractures ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Humans ; Joints ; Research Personnel ; Titanium ; Traction ; Weight-Bearing

The clinical observation was performed on 27 patients of acetabular fracture, who had been admitted and treated at Department of Orthopedic Surgery, Choong-ahng Gil Hospital from January 1983 to December 1986. The results obtained were as follows. 1. The prevalent age ranged from 20 to 50 years, and the ratio between males and females was 2.4:1. 2. The most common cause of injury was traffic accident. 3. According to Letournel's classification, 8 cases were posterior wall fractures, 4 cases were pure transverse fractures, 3 cases were “T” shaped fractures, and 3 cases were fractures of both column. 4. The most common associated injury of the another part of the body was pelvic bone fracture and the most common associated soft tissue injury was cerebral contusion. 5. The satisfactory result of conservative treatment was 84.6% and surgical treatment was 78.6%. 6. The complications were degenerative arthritis(66.7%), bed sore(13.3%), ectopic ossification(6.7%), sciatic nerve palsy(6.7%), pin tract infection(6.7%) respectively. 7. The accurate anatomical reduction & rigid fixation was an important factor for intraarticular fracture.
Accidents, Traffic ; Acetabulum ; Classification ; Clinical Study ; Contusions ; Female ; Humans ; Intra-Articular Fractures ; Male ; Orthopedics ; Pelvic Bones ; Sciatic Nerve ; Soft Tissue Injuries

Notch stenosis had been thought to be related with anterior cruciate ligament (ACL) injury. The purpose of this study is to evaluate the possible relationship between notch stenosis and ACL injury. We measured the notch seen on the axial section in MRI at popliteal groove. We have retrospectively analyzed 116 cases of knee MRI. All cases were divided into three groups ; Group I were fifty six normal knee. Group II were thirty knee with contact ACL injuries. Group III were thirty knee with non contact ACL injuries. The result were as follows; 1. Statistically significant difference was found in the notch width index (NWI) between group I and group III but no significant differences was found in the NWI between group I and group II. 2. Statistically significant correlation to non-contact ACL injuries was found in the NWI at both anterior and posterior outlet of the notch. 3. An unique shape of the notch was found in the majority of group III.There seemed to be an obvious relationship between notch stenosis and non-contact ACL injuries.
Anterior Cruciate Ligament* ; Constriction, Pathologic ; Knee ; Magnetic Resonance Imaging* ; Retrospective Studies

Patients with severe stroke due to acute large cerebral artery occlusion are likely to be severely disabled or die if reperfusion is not achieved in a timely manner. Intravenous tissue plasminogen activator (IV-TPA) administered within 4.5 hours after stroke onset was previously the only proven therapy, but IV-TPA alone does not sufficiently improve the outcome of patients with acute large artery occlusion. With the introduction of the advanced endovascular therapy that enables faster and more successful recanalization, recent randomized trials consecutively and consistently demonstrated the benefit of adding endovascular recanalization therapy (ERT) to IV-TPA. Accordingly, to update the recommendations, we assembled members of a writing committee appointed by the Korean Stroke Society, the Korean Society of Interventional Neuroradiology, and the Society of Korean Endovascular Neurosurgeons. The writing committee revised recommendations based on a review of the accumulated evidence, and a formal consensus was achieved by convening a panel of 34 experts from the participating academic societies. The current guideline provides evidence-based recommendations for ERT in patients with acute large cerebral artery occlusion regarding patient selection, treatment modalities, neuroimaging evaluation, and system organization.
Arteries ; Cerebral Arteries ; Consensus ; Humans ; Neuroimaging ; Neurosurgeons ; Patient Selection ; Reperfusion ; Stroke* ; Tissue Plasminogen Activator ; Writing

Patients with severe stroke due to acute large cerebral artery occlusion are likely to be severely disabled or dead without timely reperfusion. Previously, intravenous tissue plasminogen activator (IV-TPA) within 4.5 hours after stroke onset was the only proven therapy, but IV-TPA alone does not sufficiently improve the outcome of patients with acute large artery occlusion. With the introduction of the advanced endovascular therapy, which enables more fast and more successful recanalization, recent randomized trials consecutively and consistently demonstrated the benefit of endovascular recanalization therapy (ERT) when added to IV-TPA. Accordingly, to update the recommendations, we assembled members of the writing committee appointed by the Korean Stroke Society, the Korean Society of Interventional Neuroradiology, and the Society of Korean Endovascular Neurosurgeons. Reviewing the evidences that have been accumulated, the writing members revised recommendations, for which formal consensus was achieved by convening a panel composed of 34 experts from the participating academic societies. The current guideline provides the evidence-based recommendations for ERT in patients with acute large cerebral artery occlusion regarding patient selection, treatment modalities, neuroimaging evaluation, and system organization.
Arteries ; Cerebral Arteries ; Consensus ; Humans ; Neuroimaging ; Patient Selection ; Reperfusion ; Stroke* ; Tissue Plasminogen Activator ; Writing

Patients with severe stroke due to acute large cerebral artery occlusion are likely to be severely disabled or dead without timely reperfusion. Previously, intravenous tissue plasminogen activator (IV-TPA) within 4.5 hours after stroke onset was the only proven therapy, but IV-TPA alone does not sufficiently improve the outcome of patients with acute large artery occlusion. With the introduction of the advanced endovascular therapy, which enables more fast and more successful recanalization, recent randomized trials consecutively and consistently demonstrated the benefit of endovascular recanalization therapy (ERT) when added to IV-TPA. Accordingly, to update the recommendations, we assembled members of the writing committee appointed by the Korean Stroke Society, the Korean Society of Interventional Neuroradiology, and the Society of Korean Endovascular Neurosurgeons. Reviewing the evidences that have been accumulated, the writing members revised recommendations, for which formal consensus was achieved by convening a panel composed of 34 experts from the participating academic societies. The current guideline provides the evidence-based recommendations for ERT in patients with acute large cerebral artery occlusion regarding patient selection, treatment modalities, neuroimaging evaluation, and system organization.
Arteries ; Cerebral Arteries ; Consensus ; Humans ; Neuroimaging ; Patient Selection ; Reperfusion ; Stroke* ; Tissue Plasminogen Activator ; Writing

alpha-Mangostin is a xanthon derivative contained in the fruit hull of mangosteen (Garcinia mangostana L.), and the administration of alpha-Mangostin inhibited the growth of transplanted colon cancer, Her/CT26 cells which expressed Her-2/neu as tumor antigen. Although alpha-Mangostin was reported to have inhibitory activity against sarco/endoplasmic reticulum Ca2+ ATPase like thapsigargin, it showed different activity for autophagy regulation. In the current study, we found that alpha-Mangostin induced autophagy activation in mouse intestinal epithelial cells, as GFP-LC3 transgenic mice were orally administered with 20 mg/kg of alpha-Mangostin daily for three days. However, the activation of autophagy by alpha-Mangostin did not significantly increase OVA-specific T cell proliferation. As we assessed ER stress by using XBP-1 reporter system and phosphorylation of eIF2alpha, thapsigargin-induced ER stress was significantly reduced by alpha-Mangostin. However, coadministration of thapsigargin with alpha-Mangostin completely blocked the antitumor activity of alpha-Mangostin, suggesting ER stress with autophagy blockade accelerated tumor growth in mouse colon cancer model. Thus the antitumor activity of alpha-Mangostin can be ascribable to the autophagy activation rather than ER stress induction.
Animals ; Autophagy ; Calcium-Transporting ATPases ; Cell Proliferation ; Colonic Neoplasms ; Epithelial Cells ; Fruit ; Garcinia mangostana ; Mice ; Mice, Transgenic ; Phosphorylation ; Reticulum ; Thapsigargin ; Transplants ; Xanthones

Objective: We aimed to investigate whether 2-[ 18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[ 18F]FDG PET/CT) can aid in evaluating the risk of malignancy in ampullary tumors detected by endoscopy. Materials and Methods: This single-center retrospective cohort study analyzed 155 patients (79 male, 76 female; mean age, 65.7 ± 12.7 years) receiving 2-[ 18F]FDG PET/CT for endoscopy-detected ampullary tumors 5–87 days (median, 7 days) after the diagnostic endoscopy between June 2007 and December 2020. The final diagnosis was made based on histopathological findings. The PET imaging parameters were compared with clinical data and endoscopic features. A model to predict the risk of malignancy, based on PET, endoscopy, and clinical findings, was generated and validated using multivariable logistic regression analysis and an additional bootstrapping method. The final model was compared with standard endoscopy for the diagnosis of ampullary cancer using the DeLong test. Results: The mean tumor size was 17.1 ± 7.7 mm. Sixty-four (41.3%) tumors were benign, and 91 (58.7%) were malignant. Univariable analysis found that ampullary neoplasms with a blood-pool corrected peak standardized uptake value in earlyphase scan (SUVe) ≥ 1.7 were more likely to be malignant (odds ratio [OR], 16.06; 95% confidence interval [CI], 7.13–36.18;P < 0.001). Multivariable analysis identified the presence of jaundice (adjusted OR [aOR], 4.89; 95% CI, 1.80–13.33; P = 0.002), malignant traits in endoscopy (aOR, 6.80; 95% CI, 2.41–19.20; P < 0.001), SUVe ≥ 1.7 in PET (aOR, 5.43; 95% CI, 2.00–14.72; P < 0.001), and PET-detected nodal disease (aOR, 5.03; 95% CI, 1.16–21.86; P = 0.041) as independent predictors of malignancy. The model combining these four factors predicted ampullary cancers better than endoscopic diagnosis alone (area under the curve [AUC] and 95% CI: 0.925 [0.874–0.956] vs. 0.815 [0.732–0.873], P < 0.001). The model demonstrated an AUC of 0.921 (95% CI, 0.816–0.967) in candidates for endoscopic papillectomy. Conclusion Adding 2-[ 18F]FDG PET/CT to endoscopy can improve the diagnosis of ampullary cancer and may help refine therapeutic decision-making, particularly when contemplating endoscopic papillectomy.