Liver biopsies are used routinely in the assessment of graft dysfunction following liver transplantation and generally considered to be the most reliable method for the diagnosis of posttransplant complications with overlapping clinical and laboratory findings. To investigate posttransplant complications causing graft dysfunction and usefulness of liver biopsy, we analysed clinicopathologic features of 65 posttransplant liver biopsies, 2 autopsies and an explanted liver, taken from 20 patients. The frequencies of posttransplant complications were acute cellular rejection in 9 patients (45%), postoperative infection in 11 patients (55%), of which cytomegalovirus (CMV) infection and systemic invasive aspergillosis with candidiasis occured in 10 patients (50%) and 1 patient (5%), respectively. Remainders were hepatic arterial thrombosis in two (10%), primary graft dysfunction due to fatty donor liver in one (5%), and posttransplant lymphoproliferative disorder (PTLD) in two (10%). There were no chronic rejection or recurrent disease. Postoperative mortality was 25%. Histologic grade by Banff schema was well correlated with clinical parameters associated with unfavorable short term prognosis. CMV infection was associated with acute cellular rejection in 6 out of 10 patients (60%). Immunohistochemical staining for CMV was more sensitive method than CMV in situ hybridization or histologic detection of viral inclusion on tissue section. It was unique that one case of PTLD developed under the circumstances of the lowest dosage of immunosuppression and took grave outcome. Based on these results, we concluded that clinicopathologic correlation with integration of all the clinical and laboratory findings is necessary in the interpretation of accurate and early diagnosis of posttransplant liver biopsies. The interrelationship between chronic rejection and CMV infection as well as pathogenetic factors of PTLD remains to be clarified through further ongoing observation.
Aspergillosis ; Autopsy ; Biopsy* ; Candidiasis ; Cytomegalovirus ; Diagnosis ; Early Diagnosis ; Humans ; Immunosuppression ; In Situ Hybridization ; Liver Transplantation ; Liver* ; Lymphoproliferative Disorders ; Mortality ; Primary Graft Dysfunction ; Prognosis ; Thrombosis ; Tissue Donors ; Transplants

No abstract available.
Hemorrhagic Fever with Renal Syndrome*

39 patients with tibial shaft fracture had treated by open reduction and internal fixation with AO DCP and screws applying on the medial surface of the tibia, at the Department of Orthopedic Surgery, Ulsan Dongkang Hospital, from January, 1983 to December, 1985. A clinical study was done on all the 39 cases with the follow-up check over 1 year. In general, because the lateral surface of the tibia is well covered by rich soft tissue, it is popularized to apply the plate on the lateral aspect of the tibia. In our department, we applied the plate on the medial aspect of the tibia, which resulted in mimi-zing soft tissue injuries and, by inserting the screws perpendicular to the surface of the bone, increased stability of the fixation; and therefore resulted in relatively short operation time, relatively low incidences of infection and non-union; but there had been some drawbacks such as focal skin necrosis, hematoma, adhesion after fixatives removal, and cosmetic disfiguring. But there were no problems during the follow up periods. So, this is a recommandable procedure of internal fixation with the plate for the tibial shaft fractures.
Clinical Study ; Fixatives ; Follow-Up Studies ; Hematoma ; Humans ; Incidence ; Necrosis ; Orthopedics ; Skin ; Soft Tissue Injuries ; Tibia ; Ulsan

PURPOSE: To analyze factors influencing clinical results after microfracture surgery in patients with osteoarthritic knee. MATERIALS AND METHODS: After microfracture surgery, in sixty-six patients with sixty-eight knees having full thickness chondral defect by arthroscopic evaluation, clinical results were evaluated with Baumgartner's nine-point scale during the follow-up of 1 year 4 months (range, 1-2 years 5 months). Results were analyzed according to age, the degree of preoperative varus and the existence of flexion contracture. RESULTS: Sixty-three knees showed excellent or good results at clinical evaluation. According to age, a significant difference was observed about 65 years old (p<0.05). The patients without flexion contracture and with less varus change had better clinical results, as did patients whose medial deviation of mechanical axis was less than 75% (p<0.05). CONCLUSION: Better clinical results, after microfracture surgery, were obtained in patients who were under the age of 65, with less than 75% of medial deviation of the mechanical axis on standing AP radiogram and no flexion contracture.
Aged ; Axis, Cervical Vertebra ; Contracture ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis

Acute peripheral vestibulopathy, of which the chief complaint is positional vertigo, comprises benign paroxysmal positional vertigo (BPPV), labyrinthitis, labyrinthine fistula, and cerebellopontine angle tumors. Since the typical presentation of labyrinthine fistulas may be sensorineural hearing loss, positional vertigo, or disequilibrium, it is often difficult to distinguish from BPPV or Meniere's disease. Herein we report a 61-year-old female patient with typical symptoms and signs attributable to geotropic type variant of the lateral semicircular canal BPPV on the left side, who eventually was confirmed as having a labyrinthine fistula from chronic otitis media with cholesteatoma on the left side. This is another case where, even in the presence of isolated vertigo showing typical findings of acute peripheral vestibulopathy, other otologic symptoms and signs must not be overlooked.
Cholesteatoma* ; Ear, Inner ; Female ; Fistula* ; Hearing Loss, Sensorineural ; Humans ; Labyrinthitis ; Meniere Disease ; Middle Aged ; Neuroma, Acoustic ; Otitis Media ; Semicircular Canals ; Vertigo* ; Vestibular Neuronitis

The non-metric analysis of the skulls is very useful for estimating sex and determination of ancestry, the accuracy tends to depend on the amount of experiences of the observers, and so inter-observer errors might be happened. Many researchers are trying to find out more objective methods for determination of ancestry. The purpose of this presentation is to show the usefulness of moire contourography for analyzing the skull. The master screen that is similar to the gratings was made by steel rods, which were arranged as equally spaced parallel lines. Halogen light source was illuminated by lantern slide projector. The skeletal materials were documented crania, composed of 87 male and 47 female, from William M. Bass Donated Skeletal Collection housed at the Department of Anthropology, University of Tennessee. The skulls were placed just behind the master screen as anatomical position using cubic craniophore. The angle between the light source and camera was 65degrees, the distance between camera and the master screen was 1.2 m. Frontal view, left lateral and right lateral view were taken. From the frontal view, fringe patterns were analyzed for first five contour lines which were mainly located around the Glabella. The results were as followed; Type I for male was 53% and female was 4%; Type II for male was 29% and female was 2%; Type III for male was 2% and female was 15%; Type IV for male was 6% and female was 55%. From the lateral view, fringe patterns were analyzed for first four contour lines. However, first and second contour lines were critical to determine the shape and the results were as followed; Type I for male was 52% and female was 22%; Type II for male was 38% and female was 26%; Type III for male was 8% and female was 17%; Type IV for male was 2% and female was 35%. According to this study, different fringe patterns might be dependent on the degree of development of bone marker such as Glabella, Supercillary arch, Euryon and Mastoid process. For example, Supercillary arches were very well developed and slope of forehead above the Glabella was declined, fringe pattern showed reverse triangle shape. If Supercillary arches were poorly developed and slope of forehead above the Glabella was flat, fringe pattern showed home plate shape. The present research shows that moire contourography might be used as more objective methods for estimating sex. And it would be helpful to determine the ancestry when the lateral aspects were analyzed. In the future, continuing study need to be performed with same master screen for different ancestry.
Anthropology ; Bass ; Female ; Forehead ; Humans ; Male ; Mastoid ; Skull* ; Steel ; Tennessee

A retrospective analysis of the ultrasonographic findings of 9 cases of tuberculous abscess, 5 cases of pyogenic abscess and 2 cases of hematoma of psoas and adjacent muscles was made. Fluid collection with or without internal echoes was seen in 12 cases out of total 16 cases. Other findings were 2 cases of only muscle swelling, 1 case of highly echogenic mass.like appearance and 1 case of fluid collection with septae. Ultrasonography is considered an accurate method in identifying early pathologic changes of the psoas muscle and determining its extent. and in differentiating tumor from fluid collection of the psoas muscle. Authors dare to say that ultrasound examination is a procedure of choice in the diagnosis of psoas abscess and hematoma.
Abscess ; Diagnosis ; Hematoma ; Methods ; Muscles ; Psoas Abscess ; Psoas Muscles ; Retrospective Studies ; Ultrasonography

PURPOSE: Reexpansion pulmonary edema (REPE) is a rare but potentially lethal complication of treatment for pneumothorax. This study was designed to compare the frequency of REPE after treatment of primary spontaneous pneumothorax (PSP) with 6 French (Fr) small bore catheterization and 14-20 Fr chest tube thoracostomy. METHODS: The medical records of PSP patients treated with thoracostomy from January 2010 to May 2015 were reviewed retrospectively. We compared the group treated using a 6 Fr small bore catheter with the group treated using a 14-20 Fr chest tube for clinical and demographic factors. The main outcome was the frequency of REPE between the two groups. RESULTS: A total of 196 patients were enrolled. No significant differences in catheter indwelling time, lengths of hospital stay, and treatment failures were observed between the two groups. REPE developed in 21 patients (10.7%). The frequencies of REPE after 6 Fr small bore catheter and 14-20 Fr chest tube were 6.0% (7 of 114 patients) and 17.1% (14 of 82 patients), respectively (p=0.015). In logistic regression analysis, drainage via 14-20 Fr chest tube showed significant correlation with the occurrence of REPE (odds ratio=3.03, p=0.038). CONCLUSION: A 6 Fr small bore catheter offers a safe and effective alternative to a chest tube for treatment of pneumothorax. We suggest that drainage via a small bore catheter should be considered as the initial treatment of choice for PSP patients in terms of frequency of development REPE.
Catheterization* ; Catheters* ; Chest Tubes* ; Demography ; Drainage ; Humans ; Length of Stay ; Logistic Models ; Medical Records ; Pneumothorax* ; Pulmonary Edema* ; Retrospective Studies ; Thoracostomy* ; Thorax* ; Treatment Failure

The incidence of a primary central nervous system (CNS) lymphoma in western countries is about 1% of all the intracranial tumors and has increased 2.2% over the last decade. A similar pattern of increased frequency is observed in Korea. Although most CNS lymphomas in western countries are high grade tumors carrying poor prognosis, the clinicopathologic features of the Korean CNS lymphoma have not been well studied. We report clinicopathological features of 18 cases of histologically proven primary brain lymphoma. The mean age of the patients was 50 years and there was no sex difference. The clinical and radiological characteristics included multiple site of occurrence, infrequent extracranial spread, and frequent seeding via cerebrospinal fluid. No patients were immune-compromised host. Of 18 cases, 15 cases were of B-lineage and 2 cases were of T-lineage. According to REAL classification, there were 12 cases of diffuse large B cell lymphoma, two cases of B cell lymphomas of small lymphoid cell, and two cases of peripheral T cell lymphoma, unspecified. The remaining subtypes were not subclassified because of inadequate material. Pleomorphic cytologic features and necrosis of varying extent were frequent in the cases of diffuse large B-cell lymphoma. These results suggest that overall clinicopathologic features of primary malignant lymphomas of the central nervous system in Korea are similar to those of western countries.
Brain ; Central Nervous System* ; Cerebrospinal Fluid ; Classification ; Humans ; Incidence ; Korea ; Lymphocytes ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, T-Cell, Peripheral ; Necrosis ; Prognosis ; Sex Characteristics

Eagle's syndrome is a rare condition associated with recurrent throat pain, foreign body sensation and odynophagia. It is caused by elongation of the styloid process or calcification of the stylohyoid process. We present the clinical and radiologic findings of a case of Eagle's syndrome.
Foreign Bodies ; Pharynx ; Sensation