A prospective study had been performed in infants with hydronephrosis due to ureteropelvic junction stenosis to determine adequate management plan. Forty infants (47 renal units) were selected for the study during the period from January 1995 to July 1997 in the Department of Pediatrics, Asan Medical Center. They were diagnosed prenatally or early postnatally (<3 months of age) on the basis of renal ultrasonography and techotium-99m-mercap- toacetyltriglycerine (MAG3) scan. The antero-poste- rior pelvic diameter (APPD) was measured from serial renal ultrasonography and relative renal function and clearance half time (T1/2) were calculated from serial MAG3 scan. Those who had accompanying other urogenital anomalies or vesicoureteral reflux were excluded in this study. Follow-up tests (ultrasonography and MAG3 scan) and surgical corrections, if necessary, were performed according to the predetermined algorithrn. The male to female ratio was 3: 1. Hydronephrosis was involved the left side in 24 renal units, the right side in 9 renal units, and the bilateral sides in 14 renal units. All the hydronephrotic renal units were divided into 2 groups; Group A (19 renal units) those had taken surgical correction, and group B (28 renal units) those revealed spontaneous improvement without surgical correction. The mean follow-up duration was 7.2+/-6.3 months in group A and 14.1+/-12.6 months in group B. The mean APPD in the first postnatal renal ultrasonography was 19.4+6.8 mm in group A and 10.0+/-3.0mm in group B and this was statistically significant (P<0.01). The rela- tive renal function of group A in the first MAG3 scan was under 35% in 7 renal units and over 35M in 12 renal units. In group B, the relative renal function was over 35% in the all 28 renal units. Tl/2 in the first MAG3 scan was longer than 20 minutes in the all 19 renal units in group A. In group B, Tl/2 was shorter than 10 minutes in 15 renal units, between 10 minutes and 20 minutes in 6 renal units, and longer than 20 rninutes in 7 renal units. The mean APPD of the 7 renal units in group B of which Tl/2 was longer than 20 minutes was 12.62.6mm and that of group A was 19.4+/-6.8mrn and this was statistically significant (P<0.01). In conclusion, the renal ultrasonography and MAG3 scan can be used effectively to determine the degree of the stenosis of the ureteropelvic junction in hydronephosis during infancy. When the babies are diagnosed with hydronephrosis due to ureteropelvic junction stenosis in the early infantile period, serial renal ultrasonography and MAG3 scan play an important role in the decision of the management.
Chungcheongnam-do ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis* ; Infant ; Male ; Pediatrics ; Ultrasonography* ; Vesico-Ureteral Reflux

No abstract available.

No abstract available.

No abstract available.
Heel* ; Molluscum Contagiosum* ; Weight-Bearing* ; Zea mays

Lupus panniculitis is a rare disease that may present with similar clinical manifestations to an infection, such as cellulitis or abscess. This paper reports a case of a 25-year-old woman with systemic lupus erythematosus who underwent surgical intervention initially with the suspicion of an abscess but who was eventually diagnosed with lupus panniculitis. Despite the low incidence of lower leg involvement of panniculitis, clinicians should be aware of the possibility of an etiology other than infection when encountering patients with inflammatory diseases. Moreover, a skin biopsy and magnetic resonance imaging with a diffusion-weight image may be helpful.

OBJECTIVE: The purpose of this study was to evaluate the outcome and safety of vaginal delivery after previous cesarean birth. METHODS: This study was based on 303 cases of delivery with previous cesarean birth at Masan, Fatima Hospital from May, 1997 to April, 1998. Among them, 62 cases had performed trial of labor. We had made a comparison between elective repeat section group and trial of labor group by analizing the frequency, successful rate, maternal morbidity, perinatal morbidity and mortality. RESULTS: Among 303 cases with previous cesarean birth, trial of labor was done in 62 cases(20.5%). Among trial of labor group, vaginal delivery was done in 54 cases (87.1%) and repeat section was done in 8 cases(12.9%). Indications for elective repea section before the onset of labor were refuse trial of labor(51.9%), request for tubal ligation(17.4%), and previous section > or =2(7.5%), etc. The successful rate of vaginal delivery according to indication for previous cesarean birth was 85.0%(17/20) in the cases of dystocia and 88.1%(37/42) in the cases except dystocia. The successful rate was not influenced by the indication for previous cesarean birth(P>0.05). There were no maternal death or uterine rupture in the cases of trial of labor. There were no significant difference between elective repeat section group and trial of labor group in maternal morbidity, perinatal morbidity and mortality(P>0.05). CONCLUSION: Under strict indications, vaginal delivery subsequent to cesarean birth may be safe, and can reduce the rate of cesarean section that was increased constantly.
Apgar Score ; Cesarean Section ; Dystocia ; Eclampsia* ; Female ; Fetal Distress ; Fetus ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Maternal Death ; Mortality ; Parturition ; Parturition* ; Perinatal Mortality ; Pre-Eclampsia* ; Pregnancy ; Premature Birth ; Respiration, Artificial ; Rheology ; Trial of Labor ; Umbilical Arteries* ; Uterine Rupture

Chondroblastoma is a rare primary neoplasm of bone which involves the epiphysis of the long bone and develops mostly in the 2nd decade of life. We reviewed the cases of twenty patients with chondroblastoma who were treated at the Department of Orthopaedic Surgery, Yonsei University College of Medicine between 1969 and 1989. All patients were followed for 1 year or longer. The results were as follows. 1. The proximal end of the humerus(25%) and the proximal end of the femur(25%) were the most common sites. 2. 85% of patients were between 11 to 20 years old and male to female ratio was 3:2. 3. The most common symptom was pain and in 30% of patients it was appeared after minor trauma. 4. The average diameter of lesion is 4.2cm in its long axis and the more longer the duration, the more larger the size of lesion. 5. Involvement of the epiphyseal plate was twice as common in the patients with a closing plate as in those with an open one. 6. The most common microscopic finding was the presence of chondroblast and chondroid matrix. 7. Two patients(10%) had a local recurrence. 8. The final functional results were considered to be good in sixteen(80%) patients. 9. Accurste localization of the lesion during biopsy is very important especially in the case of deep seated lesion.
Biopsy ; Chondroblastoma ; Chondrocytes ; Epiphyses ; Female ; Growth Plate ; Humans ; Male ; Recurrence

Akt, heat shock protein (HSP72)72, and HSP90 induced by ischemic preconditioning protect cells from the ischemic injury. The purpose of this study was to examine the alterations of the level of phospho-Akt, HSP72, and HSP90 in the rat tibialis anterior and soleus muscles after cyclic episodes of ischemic preconditioning. Sprague-Dawley rats aged 35 weeks were divided into control and ischemic preconditioning (IP) groups. The IP group was divided into 3 subgroups based on cycles of IP. Left common iliac artery was occluded 3, 6, and 10 times for 5 minutes, followed by 5 minutes reperfusion. The experimental animals were sacrificed at 0, 3, 6, 24, and 72 hours after reperfusion, and left tibialis anterior and soleus muscles were removed. The expression of phospho-Akt, HSP72, and HSP90 were examined with immunohistochemical methods and Western blot analysis. The results were as follows; 1. In the 3 and 6 times of IP groups, the expression of phospho-Akt (p-Akt) was increased at 0 and 3 hours after reperfusion, compared with control group. The expression of p-Akt in the 10 times of IP group was lower than that in 3 and 6 times of IP groups. At 72 hours after reperfusion, the expression of p-Akt showed no difference among the IP groups. The expression of p-Akt was higher in Soleus than that in Tibialis anterior. 2. The expression of HSP72 in 3 times of IP group increased at 0 and 3 hours after reperfusion, compared with 6 and 10 times of IP groups. The expression of HSP72 in the 10 times of IP group was lower than that in 3 and 6 times of IP groups. At 72 hours after reperfusion, the expression of HSP72 showed no difference among the IP groups. The expression of HSP72 was higher in Soleus than that in Tibialis anterior. 3. In the 3 and 6 times of IP groups, the expression of HSP90 increased at 0 and 3 hours after reperfusion, compared with control group. The expression of HSP90 in the 10 times of IP group was lower than that in 3 and 6 times of IP groups. At 24 hours after reperfusion, the expression of HSP90 showed no difference with increasing episode of IP. The expression level of HSP90 was higher in Soleus than that in Tibialis anterior. These findings suggest that ischemic preconditioning increases the expression of p-Akt, HSP72 and HSP90 at early phase after reperfusion in the rat tibialis anterior and soleus muscles. However, increased cycles of ischemic preconditioning may not induce the expression of them.
Animals ; Blotting, Western ; Heat-Shock Proteins ; Iliac Artery ; Ischemic Preconditioning* ; Muscles* ; Phosphorylation* ; Rats* ; Rats, Sprague-Dawley ; Reperfusion

Background: The purpose of this study was to evaluate the clinical and radiological outcomes of high-flexion total knee arthroplasty (TKA) using Vega Knee System (B. Braun, Aesculap) at a long-term follow-up and to analyze the implant survivorship. Methods: We enrolled 165 patients (232 knees) with a minimum 7-year follow-up after TKA (VEGA Knee System). For clinical assessment, range of motion (ROM), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used. For radiologic assessment, hip-knee-ankle angle, component position, and the existence of radiolucent lines and loosening were used. Survival analysis was conducted using the Kaplan-Meier method. Results: The mean follow-up period was 9.8 years. The mean ROM increased from 124.4° to 131.4° at the final follow-up. The WOMAC score decreased from 38.5 to 17.4 at the final follow-up (p < 0.001). All 5 subscales of the KOOS improved at the final follow-up (all subscales, p < 0.001). Revision TKA was performed in 10 cases (4.3%), which included 9 cases of aseptic loosing and 1 case of periprostatic joint infection. Of the 9 aseptic loosening cases (3.9%), 8 cases (3.4%) were loosening of the femoral component and 1 case (0.4%) was loosening of the tibial component. When revision for any reason was considered an endpoint, the 10-year survivorship was 96.2% (95% confidence interval [CI], 93.9%–98.5%). On the other hand, when revision for aseptic loosening was considered the endpoint, the 10-year survivorship was 96.6% (95% CI, 94.4%–98.8%). Conclusions The Vega Knee System provided good clinical results in the long-term follow-up period. Although the VEGA Knee System showed acceptable implant survivorship, loosening of the femoral component occurred in about 3.4% of the patients. For more accurate evaluation of the survivorship of high-flexion design TKA with a short posterior flange, it is necessary to conduct more long-term follow-up studies targeting diverse races, especially Asians who frequently perform high-flexion activities.

Purpose: Current faculty development (FD) programs are mostly limited to medical education and often lack a comprehensive and systematic structure. Therefore, the present study aimed to explore the current status and needs of FD programs in medical schools to provide a basis for establishing FD strategies. Methods: We conducted an online survey of medical school FD staff and professors regarding FD. Frequency, regression, and qualitative content analyses were conducted. FD programs were categorized into the classification frameworks. Results: A total of 17 FD staff and 256 professors at 37 medical schools participated. There are gaps between the internal and external FD programs offered by medical schools and their needs, and there are gaps between the programs the professors participated in and their needs. Recent internal and external FD programs in medical schools have focused on educational methods, student assessment, and education in general. Medical schools have a high need for leadership and self-development, and student assessment. Furthermore, professors have a high need for leadership and self-development, and research. The number of participants, topics, and needs of FD programs varied depending on the characteristics of individual professors. Conclusion Medical schools should expand their FD programs to meet the needs of individuals and the changing demands of modern medical education. The focus should be on comprehensive and responsive programs that cover various topics, levels, and methods. Tailored programs that consider professors’ professional roles, career stages, and personal interests are essential for effective FD.