Extrapleural hematoma results from blood accumulating between the parietal pleura and the endothoracic fascia, whereas hemothorax shows pooling in the pleural space. Extrapleural hematoma results from an intact parietal pleura that blocks blood from escaping the pleural cavity. Extrapleural fat, a fat layer outside the pleura in the chest wall between the parietal pleura and the endothoracic fascia, is pathognomonic on computed tomography. We diagnosed traumatic extrapleural hematoma and treated it with video-assisted thoracic surgery. We report here on this case along with a review of the literature.
Fascia ; Hematoma ; Hemothorax ; Pleura ; Pleural Cavity ; Thoracic Surgery, Video-Assisted ; Thoracic Wall ; Thoracoscopy ; United Nations

Glycyrrhizin (GR), triterpenoid saponin composed of one glycyrrhetinic acid (GA) and two glucuronic acids, is a main constituent of the hydrophilic fraction of licorice (Glycyrrhiza glabra) extracts and is known to have a wide range of pharmacological actions. In this study, we investigated the mechanism of GR effect on melanogenesis in B16 murine melanoma cells. The cellular levels of tyrosinase mRNA, protein, enzyme activities and melanin contents were increased by GR in a dose dependent manner. Expression of tyrosinase-related protein-2 (TRP-2) mRNA was also increased by GR, however, no significant change was observed on TRP-1. No cytotoxicity was observed at the effective concentration range of GR. GA showed no effect on melanogenesis at the equivalent nontoxic concentrations, indicating that glycoside structure is important in the stimulatory effect of GR on melanogenesis. These results indicate that GR-induced stimulation of melanogenesis is likely to occur through the transcriptional activation.
Animal ; Blotting, Western ; Glycyrrhetinic Acid/pharmacology ; Glycyrrhizic Acid/*pharmacology ; Intramolecular Oxidoreductases/genetics/metabolism ; Melanins/*biosynthesis ; Melanoma, Experimental/enzymology/*metabolism ; Mice ; Monophenol Monooxygenase/genetics/metabolism ; Proteins/genetics/metabolism ; Reverse Transcriptase Polymerase Chain Reaction

Making a precise and ideal set-up model is an essential part in the indirect bonding procedure for lingual orthodontic treatment. To evaluate the accuracy of the making a set-up model, 22 adult patients who received lingual orthodontic treatment with 4 bicuspid extractions were selected, and 3 sets of dental models (before, set-up, and after treatment) were measured using the set-up model gauge, an instrument for measuring the inclination and angulation of the clinical crowns on the dental model. Two sets of lateral cephalograms (before and after) from each patient were also evaluated. The mean difference between the before treatment model and the set-up model was -3.93 +/- 6.98 degrees for the inclination and 1.87 +/- 5.79 degrees for the angulation. And the mean difference between the set-up model and the after treatment model was -4.31 +/- 5.91 degrees labiolingually and -2.16 +/- 3.27 degrees mesiodistally. The after treatment model differed from the before treatment model about -8.24 +/- 5.39 degrees in inclination. There were no significant difference between the measured gauge that measured from the dental model using the set-up model gauge and the calculated gauge angle measured from the lateral cephalogram using constructed points and lines. Using the set-up model gauge, it is possible to evaluate the study model 3-dimensionally in relation with the patient's lateral cephalogram and establish whether the doctor's prescription or overcorrection is built in the set-up model precisely.
Adult ; Bicuspid ; Crowns ; Dental Models ; Humans ; Prescriptions

OBJECTIVE: To evaluate which Korean pain descriptors are frequently used in the patients with neuromusculoskeletal diseases and compare the frequency of Korean pain descriptor according to age, gender, pain pattern and intensity, and clinical diagnosis.METHOD: Two hundreds sixty nine patients with neuromusculoskeletal diseases were enrolled in this study. The patients were asked to fill out a pain questionnaire using Korean. The Korean pain descriptors were collected and classified according to neurophysiological mechanism. The frequency of Korean pain descriptor was analyzed by age, gender, pain pattern and intensity, and clinical diagnosis. They were divided into axial spine and peripheral joint pain group depending on the location of causal disease and shoulder pain descriptors were divided into intra-articular and bursa group.RESULTS: Among 24 Korean pain descriptors, ‘arida’ was the most common pain descriptor, followed by ‘ssusida’ and ‘jjireunda’. When the pain descriptors were classified according to neurophysiological mechanism, superficial somatic pain was the most common, followed by deep somatic pain. There was a significant difference in the frequency of the pain descriptor between axial spine and peripheral joint pain group (p=0.007). The pain descriptor ‘danggida’ was used significantly more in the patients with axial spine pain than peripheral joint pain (p=0.024). However, there was no significant difference in other factors.CONCLUSION: The patients with neuromusculoskeletal diseases expressed their pain using various Korean pain descriptors with stabbing nature and superficial somatic pain. Our results may be helpful to assess and develop a new Korean pain quality measure in the patients with neuromusculoskeletal diseases.
Arthralgia ; Diagnosis ; Humans ; Methods ; Musculoskeletal Pain ; Neuralgia ; Nociceptive Pain ; Sensation ; Shoulder Pain ; Spine ; Subject Headings

Mechanical complications of acute myocardial infarction which may lead to heart failure or shock include ruptute of left ventricular free wall, ventricular septum and papillary muscle. The clinical characteristics of these lesions vary conservative management alone has high mortality rate, for which reason surgical repair of these defects are essential. Structural defects including rupture of the left ventricular free wall, ventricular septum, and papillary muscle, accout for 5% to 20% of all deaths from acute myocardial infarction. Among these, ventricular septal defects occur in approximately 1% of all myocardial infarction, and account for up to 2% of deaths subsequent to myocardial infarction. Rupture of the ventricular septum following acute myocardial infarction(AMI) is associated with high mortality rate, as 54% of the patients succumb within two weeks, 87% within two months and 92.5% during the first year. We experienced two cases of postinfarct ventricular septal defects(VSD) which had been repaired within 1 week after AMI due to progressive deterioration of patients` conditions, and were to be reoperated because of repeated septal ruptures in postoperation period and development of cardiogenic shock.
Heart Failure ; Heart Septal Defects, Ventricular ; Humans ; Infarction* ; Mortality ; Myocardial Infarction ; Papillary Muscles ; Rupture ; Shock ; Shock, Cardiogenic ; Ventricular Septum

We report the case of a 67-year-old woman presenting with epigastric pain. Computed tomography identified diffuse phlegmonous esophagitis. Esophagogastroduodenoscopy revealed multiple perforations in the mucosal layer of the esophagus. A large amount of pus was drained internally through the gut. The patient was treated with antibiotics and early jejunostomy feeding. Although phlegmonous esophagitis is a potentially fatal disease, the patient was successfully treated medically with only a minor complication (esophageal stricture).
Aged ; Anti-Bacterial Agents ; Cellulitis* ; Drainage* ; Endoscopy, Digestive System ; Esophagitis* ; Esophagus ; Female ; Humans ; Jejunostomy* ; Suppuration

This study was designed to investigate the position of anteroposterior center of resistance for genuine intrusion and the mode of change of the minimum distal force for simultanous intrusion and retraction of the upper and lower incisors according to the increase of labial inclination. For this purpose, we used the three-piece intrusion arch appliance and three-dimensional finite element models of upper and lower incisors. 1. Positions of the center of resistance in upper incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 6mm behind the distal surface of the lateral incisor bracket. 2) In 10degrees increase of the labial inclination situation, the center of resistance was located in 9mm behind the distal surface of the lateral incisor bracket. 3) In 20degrees increase of the labial inclination situation, the center of resistance was located in 12m behind the distal surface of the lateral incisor bracket. 4) In 30degrees increase of the labial inclination situation, the center of resistance was located in 16m behind the distal surface of the lateral incisor bracket. 2. Positions of the center of resistance in lower incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 10mm behind the distal surface of the lateral incisor bracket. 2) In 10degrees increase of the labial inclination situation, the center of resistance was located in 13mm behind the distal surface of the lateral incisor bracket. 3) In 20degrees increase of the labial inclination situation, the center of resistance was located in 15m behind the distal surface of the lateral incisor bracket. 4) In 30degrees increase of the labial inclination situation, the center of resistance was located in 18m behind the distal surface of the lateral incisor bracket. 3. The patterns of stress distribution were as follows; 1) There were even compressive stresses in and periodontal ligament when intrusion force was applied through determined center of resistance. 2) There were gradual increase of complexity in compressive stress distribution pattern with increase of the labial inclination when intrusion and retraction force were applied simultaneously.
Finite Element Analysis* ; Incisor* ; Periodontal Ligament

No abstract available.
Kidney* ; Rhabdomyolysis* ; Transplantation*

BACKGROUND: For treatment of pneumothorax in Korea, many institutions hospitalize the patient after chest tube insertion. In this study, a portable small-bore chest tube (Thoracic Egg; Sumitomo Bakelite Co. Ltd., Tokyo, Japan) was used for pneumothorax management in an outpatient clinic. METHODS: Between August 2014 and March 2015, 56 pneumothorax patients were treated using the Thoracic Egg. RESULTS: After Thoracic Egg insertion, 44 patients (78.6%) were discharged from the emergency room for follow-up in the outpatient clinic, and 12 patients (21.4%) were hospitalized. The mean duration of Thoracic Egg chest tube placement was 4.8 days, and the success rate was 73%; 20% of patients showed incomplete expansion and underwent video-assisted thoracoscopic surgery. For primary spontaneous pneumothorax patients, the success rate of the Thoracic Egg was 76.6% and for iatrogenic pneumothorax, it was 100%. There were 2 complications using the Thoracic Egg. CONCLUSION: Outpatient treatment of pneumothorax using the Thoracic Egg could be a good treatment option for primary spontaneous and iatrogenic pneumothorax.
Ambulatory Care Facilities ; Chest Tubes* ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Korea ; Outpatients* ; Ovum ; Pneumothorax* ; Thoracic Surgery, Video-Assisted ; Thorax*

Intraoral lipomas are a rare clinical entity, comprising only 0.1% to 5% of all benign tumors in the intraoral cavity. A 56-year-old woman suffering from diabetes presented with this relatively rare intraoral lipoma and was treated by surgical excision under general anesthesia. Because the mass was located adjacent to the mental foramen, a precise dissection was necessary to ensure minimal nerve damage. No abnormalities or recurrence was noted at 1-year follow-up and the patient did not complain of numbness. We studied the occurrence of oral lipoma in this diabetic patient and reviewed the relationship between oral lipoma and diabetes in the literature.
Anesthesia, General ; Female ; Follow-Up Studies ; Humans ; Hypesthesia ; Lipoma* ; Middle Aged ; Mouth* ; Recurrence