No Abstract Available.
Chondrocytes* ; Phenotype*

Congenital dislocation of the knee is very rare skeletal deformity and was firstly described by Chatelaine in 1822. Since then there have been a few number of case reports and some series discussing the etiology and treatment. The tibia is displaced anteriorly in relation to the femur. It is generally subdassified as simple hyperextention, subluxation, and dislocation depending on the degree of the joint displacement and the severity of disease. Early gentle manipulation and serial splintage or plaster cast are recommended for treatment and were successful in the majority except the case of quadriceps contrarture or late correction. The authors experienced one case of congenital dislocation of the right knee and brief review of the related literatures was made.
Casts, Surgical ; Congenital Abnormalities ; Dislocations* ; Femur ; Joints ; Knee* ; Tibia

Congenital obstuction of pulmonary vein without anomalous drainage can cause long-standing pulmonary congestion and pulmonary arterial hypertension, and it may include stenosis of individual pulmonary veinsor total pulmonary vein atresia. We reviewed seven cases of pulmonary vein obstruction, five of which accompanied other cardiac anomalies. Right pulmonary veins were involved in all seven cases including one bilateral case. Pulmonary veins were occluded totally in five and partially in three lungs. Pumonary catheterization and angiography were done for diagnosis. Chest radiographs of total occlusion cases showed decreased lung volume, features of pulmonary edema, interstitial lesions, and pleural thickening, which were quite specific, whereas pulmonry venous dilatation was dominant findings in partial obstruction cases. Pulmonary perfusion scans (n=3) showed total perfusion defects in the cases of total occlusion of veins. MR imaging (n=2) demonstrated total occlusion of pulmonary veins in the venoatrial junction in two, and membranous focal obstruction in one lung. Two patients had pneumonectomy and histological confirmation, Although catheterization and angiography are essential for the diagnosis, MR imaging is thought to be useful for the diagnosis of pulmonary vein obstruction.
Angiography ; Catheterization ; Catheters ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Drainage ; Estrogens, Conjugated (USP) ; Humans ; Hypertension ; Lung ; Magnetic Resonance Imaging ; Perfusion ; Pneumonectomy ; Pulmonary Edema ; Pulmonary Veins* ; Radiography, Thoracic ; Veins

PURPOSE: To assess the ability of the Sequential Organ Failure Assessment (SOFA) score to predict the prognosis and organ dysfunction in the paraquat poisoning. METHODS: We retrospectively evaluated 281 paraquat poisoning patients who arrived at Soonchunhyang University Cheonan Hospital between Sep 2007 and Dec 2008. Sixty eight patients (68) were excluded due to missing data. Finally, 213 patents were included in this study. We investigated the degree of paraquat exposure, the Glasgow coma scale, vital signs, blood laboratory tests, calculated SOFA score, and Yamaguchi Index on first hospital day. The prognostic prediction was compared between SOFA score and Yamaguchi Index. RESULTS: The urine dithionite test, the amount of paraquat ingestion, arrival interval, aerum paraquat, Glasgow coma scale, HCO3-, potassium, and creatinine were significantly different between survivors and non-survivors. The Hosmer and Lemeshow Goodness-of-Fitness test of SOFA score (p=0.419) and Yamaguchi Index (p=0.084) indicated a good model performance. In the logistic regression analysis, p values the SOFA score and for the Yamaguchi Index were lower than 0.05 and the odds ratios were 1.930 and 0.108. At c-statistics, the area under receiver operator characteristic curve of SOFA score was 0.807 and Yamaguchi Index was 0.865. 95% confidence SOFA score and Yamaguchi Index Intervals of did not include 0.5. CONCLUSION: The SOFA score on the first day of hospital visit could reliably describe organ dysfunction and could distinguish survivors and non-survivors with reliable accuracy, as well as the Yamaguchi Index did in the case of paraquat poisoning.
Creatinine ; Dithionite ; Eating ; Glasgow Coma Scale ; Humans ; Logistic Models ; Multiple Organ Failure ; Odds Ratio ; Paraquat ; Potassium ; Prognosis ; Retrospective Studies ; Survivors ; Vital Signs

PURPOSE: The purpose of this study is to determine whether the vertical evacuation interval, the required time for an ambulance to be dispatched after contact from a patient, increases with the number of stories above ground of a patient requesting evacuation from a high-rise building. METHODS: The rescue diary of a 119 ambulance team dispatched to Jae-Song-Dong, Busan was retrospectively reviewed for 9 months for the period from April 1 to December 31, 2006. A total of 422 cases were included as subjects in the study. Median values of the vertical evacuation intervals collected from four building story groups were evaluated and the changing trend of the vertical evacuation intervals was analyzed. RESULTS: Amang all cases, the median value of the vertical evacuation intervals and the inter-quartile range were 5.0+/-5.0 minutes. A comparison of the vertical evacuation intervals by the Kruskal-Wallis test revealed statistically significant differences between the four different story groups (p<0.001). An increase in building story number was shown to affect the vertical evacuation interval. The y-intercept was found to be 4.885, the regression coefficient was 0.133 (p<0.001), and the r-square value was 0.181. A similar result was found for patients having emergency symptoms. CONCLUSION: These results confirm that there is an increase in vertical evacuation intervals depending upon the number of stories above ground of a patients requesting emergency medical service in high-rise buildings.
Ambulances ; Elevators and Escalators ; Emergencies ; Emergency Medical Services ; Humans ; Retrospective Studies

Carbon monoxide (CO) poisoning is the most common cause of fatal poisoning in the United States and may be the most common worldwide cause of fatal poisoning. CO poisoning can affect the entire body and usually causes neurologic or cardiac injury. While not common, rhabdomyolysis, skeletal muscle necrosis, and renal failure can also occur. We report on a suicidal 22-year-old man who inhaled CO gas from a burning briquette. His case was complicated by compartment syndrome (CS). Finally, he had to undergo fasciotomy and removal of necrotic muscle. A CO poisoned patient who is unconscious cannot describe symptoms and moderate swelling or tenderness might be neglected. Though CS rarely appears in CO poisoning, delayed diagnosis may result in fatal consequences. Therefore, in the case of an unconscious patient, the entire body must be examined closely to identify early signs related to CS (tenderness, swelling, redness). If the diagnosis is uncertain after the clinical evaluation, the pressure within the compartment should be measured.
Burns ; Carbon Monoxide ; Carbon Monoxide Poisoning* ; Compartment Syndromes* ; Delayed Diagnosis ; Diagnosis ; Humans ; Muscle, Skeletal ; Necrosis ; Poisoning ; Renal Insufficiency ; Rhabdomyolysis ; United States ; Young Adult

OBJECTIVE: Radiation injury includes radiation necrosis and apoptosis. The purpose of this study is whether steroids and calcium channel blockers are effective for the prevention of single high dose irradiation-induced apoptosis in the rat brain. METHODS: Eighty Sprague-Dawley rats were divided into four experimental groups: Control(nontreated, n=20), Dexamethasone-treated(0.1mg/kg, n=20), Prednisolone-treated(2mg/kg, n=20), Nimodipine-treated (0.5mg/kg, n=20). After drug was administered, the right hemisphere of rat's brain was exposed to a single 10Gy dose of gamma rays using Ir-192. All brains underwent histological examination at 1 week, 2 weeks, 4 weeks, and 8 weeks after irradiation to evaluate cortical thickness and number of apoptotic cells. Apoptotic cells were detected by TUNEL assay. RESULTS: In nimodipine-treated group, apoptotic cell count was reduced significantly, compared to that of control(non treated) group at 4 and 8 weeks after irradiation(p<0.05). The decrease of cortical thickness was reduced significantly in nimodipine-treated group, compared to that of control group(p<0.05). There was no significant changes in the number of apoptotic cells and cortical thickness in prednisolone and dexamethasone-treated groups compared with those of control. CONCLUSION: These results suggest that nimodipine treatment may have effects on the prevention of radiation-induced apoptosis. If it could be established that calcium channel blockers inhibit radiation injury, they might be useful in radiation therapy. Further investigation of calcium channel blockers including dosage effectiveness, intracellular calcium ion concentration and effects on tumor tissue are necessary to clarify the usefulness of nimodipine.
Animals ; Apoptosis* ; Brain* ; Calcium Channel Blockers ; Calcium Channels* ; Calcium* ; Cell Count ; Dexamethasone ; Gamma Rays ; In Situ Nick-End Labeling ; Necrosis ; Nimodipine ; Prednisolone ; Radiation Injuries ; Rats* ; Rats, Sprague-Dawley ; Steroids

Abdominal lymphangiomas are uncommon angiomatous tumor occurring mainly in childhood. This is a retrospective clinicopathologic study of 17 cases of abdominal lymphangioma. The patients included are five children and 12 adults, with a mean age at initial presentation of 30.7 years (age ranges 3-63). The locations of the tumors were mesentery (5), retroperitoneum (4), colon (3), omentum (3), mesocolon (1) and gallbladder (1). Infiltrative growth was more common pattern than entirely circumscribed pattern. Masses were mostly multilocular cysts and contained chyle or serous fluid. On immunohistochemical staining, 16 cases were reactive for either CD31 or factor VIII-related antigen. These fact would suggest that intra-abdominal lymphangiomas simulate the immunohistochemical features of collecting lymphatics. Follow up was possible in 12 cases for 3-50 months (mean 19 months) and only one patient showed local recurrence. Although abdominal lymphangiomas are rare in adulthood and correct preoperative diagnosis is difficult, awareness of such a possibility in adulthood will contribute to make a correct preoperative diagnosis.
Abdominal Neoplasms/physiopathology ; Abdominal Neoplasms/pathology* ; Abdominal Neoplasms/metabolism ; Adult ; Antigens, CD31/biosynthesis ; Child ; Child, Preschool ; Factor VIII/biosynthesis ; Female ; Human ; Lymphangioma/physiopathology ; Lymphangioma/pathology* ; Lymphangioma/metabolism ; Male ; Middle Age ; Retrospective Studies

No abstract available.
Hodgkin Disease*

BACKGROUND: Portal triad clamping (PTC) during hepatic resection (Pringle maneuver, PM) can afford reduced intraoperative bleeding and bloodless surgical field. But inflow obstruction of blood to liver during PM can bring hemodynamic changes to the patient. This study was designed to evaluate the hemodynamic changes before, during and after PM application during hepatic resection. We also compared the hemodynamic effects of hepatic cooling before PM with/without portal decompression during PM. METHODS: The patients were divided into three groups; PM (P group, n=9), PM after hepatic cooling with 400 ml of 4oC lactated Ringer's solution (LR) (C+P group, n=13), PM after hepatic cooling and portal decompression with portocaval shunt (C+P+S group, n=7). Systemic vascular resistance index (SVRI), cardiac index (CI) and mean arterial pressure (MAP) were measured before, during and after PM. RESULTS: Portal pressure of C+P+S group (208.3+/-36.6 mmH2O) was lower than P (487.3+/-92.9 mmH2O) and C P (553.6+/-77.0 mmH2O) group during PM. CIs of P and C P group were decreased (15, 13% respectively) during PM. After reperfusion, CIs and SVRIs of P, C+P and C+P+S group were all increased (CI; 33, 26, 50%, SVRI; 30, 40, 50%, respectively) than end of PM. CONCLUSION: PM itself doesn't make abrupt hemodynamic change. Hepatic cooling with 4oC LR (400 ml) before PM increases MAP because of increased SVRI. Reperfusion after PM for 50 minutes, hemodynamic depression could occur by decreased SVRI, especially in case of decompressed portal pressure with portocaval shunt during PM.
Arterial Pressure ; Constriction* ; Decompression* ; Depression ; Hemodynamics* ; Hemorrhage ; Humans ; Liver ; Portal Pressure ; Reperfusion ; Vascular Resistance