A 74-year-old female patient, who underwent surgery for a left distal tibiofibular fracture 40 years earlier, visited the hospital with an ankle varus deformity due to malunion. The patient complained of discomfort while walking due to the ankle and hindfoot varus deformity but did not complain of ankle pain. Therefore, correction using supramalleolar osteotomy was planned, and through virtual surgical simulation, it was predicted that a correction angle of 24° and an osteotomy gap open of 12 mm would be necessary. An osteotomy guide and an osteotomy gap block were made using three-dimensional (3D) printing to perform the osteotomy and correct the deformity according to the predicted goal. One year after surgery, it was observed that the ankle varus was corrected according to the surgical simulation, and the patient was able to walk comfortably. Thus, for correction of deformity, virtual surgical simulation and a 3D-printed osteotomy guide can be used to predict the target value for correction. This is useful for increasing the accuracy of correction of the deformity.

No abstract available.
Child* ; Gastritis* ; Humans

No abstract available.
Thyroiditis, Autoimmune ; Turner Syndrome

PURPOSE: To report angiographic and clinical results of endovascular treatment in 45 intracranial vertebral artery dissecting aneurysms (VADAs). MATERIALS AND METHODS: From July 2002 to September 2013, a total of 42 patients with 45 VADAs received endovascular treatment. Endovascular treatment consisted of internal trapping with detachable coils, stent-assisted coiling, and stenting only. Immediate and follow-up angiographic findings and clinical outcome were retrospectively reviewed. RESULTS: There were 17 ruptured VADAs and 28 unruptured VADAs. Overall, 26 VADAs were treated with internal trapping, 14 with stent-assisted coil embolization, and 5 with stenting only. Immediate angiographic results revealed complete occlusion in 31 cases and incomplete occlusion in 14 cases. Follow-up imaging studies were available in 31 cases. On follow-up imaging, antegrade recanalization occurred in 2 of 16 cases treated with internal trapping. Aneurysmal recurrence occurred in one case treated with stent-assisted coiling. Procedural complications occurred in 8 patients. In cases of unruptured VADA, favorable outcome (mRS 0 and 1) was achieved in 26 cases and poor outcome (mRS 2-5) in 2 cases. There was no mortality in patients with unruptured VADAs. CONCLUSION: Endovascular treatment of intracranial VADA appears to be safe and effective. Follow-up angiographic study is needed because parent artery recanalization or aneurysmal recurrence can occur.
Aneurysm ; Aneurysm, Dissecting* ; Arteries ; Embolization, Therapeutic ; Follow-Up Studies* ; Humans ; Mortality ; Parents ; Recurrence ; Retrospective Studies ; Stents ; Vertebral Artery*

We report herein a 46-year-old woman who presented with mucinous breast carcinoma that appeared as a coarse and densely calcified mass on mammography. The lesion was a 4.6-cmsized palpable, hyperechoic, calcified mass with posterior shadowing on ultrasonography. This finding is a unique feature of mucinous breast carcinoma and is also observed in unusual breast cancer variants such as metaplastic breast cancer with chondroid differentiation, extraosseous osteosarcoma, and breast chondrosarcoma. The lesion showed a slow-growing pattern throughout the 4-year observation period. Mammography performed 4 years ago revealed faint, grouped microcalcifications; the lesion increased in size over 2 years, presenting as a well-circumscribed, calcified mass, mimicking dystrophic calcification. As several unusual variants of breast cancer, including mucinous carcinoma, may present as coarse and densely calcified masses on mammography, immediate biopsy should be considered when they are observed.

PURPOSE: We investigated the clinical course of infants with congenital heart disease (CHD) who experienced thyroid dysfunction within 100 days of birth. METHODS: We performed retrospective medical reviews of 54 CHD patients (24 male patients) who underwent a thyroid function test (TFT) between January 2007 and July 2016. Data were collected on birth history, diagnosis of CHD, underlying chromosomal or genetic abnormalities, medication history, surgery, ventilator care, and exposure to iodine contrast media (ICM). Results of neonatal screening tests (NSTs) and TFTs were reviewed. RESULTS: A total of 36 patients (29 transient, 7 permanent) showed thyroid dysfunction. Among the seven patients with permanent hypothyroidism, three had an underlying syndrome, three showed abnormal NST results, and one was admitted to the intensive care unit for macroglossia and feeding cyanosis. We found that infants with transient thyroid dysfunction had a lower birth weight and were more commonly exposed to thyroid disrupting medication and/or ICM. However, these risk factors were not significant. A total of 8 patients with a history of ICM exposure showed thyroid dysfunction. Excluding 3 patients with elevated thyroid stimulating hormone before ICM exposure, 5 patients recovered from transient thyroid dysfunction. CONCLUSIONS: We observed thyroid dysfunction in two-thirds of CHD infants (53.7% transient, 13.0% permanent) who had risk factors and received TFT screening within 100 days, despite normal NSTs. Further studies with larger sample sizes are required to revise the criteria for TFT screening in CHD infants.
Birth Weight ; Contrast Media ; Cyanosis ; Diagnosis ; Heart ; Heart Defects, Congenital* ; Humans ; Hypothyroidism ; Infant* ; Infant, Newborn ; Intensive Care Units ; Iodine ; Macroglossia ; Male ; Mass Screening ; Neonatal Screening ; Parturition ; Reproductive History ; Retrospective Studies ; Risk Factors ; Sample Size ; Thyroid Function Tests ; Thyroid Gland* ; Thyrotropin ; Ventilators, Mechanical

BACKGROUND AND OBJECTIVE: In assessing the health-related quality of life of subjects with allergy, it is important to measure outcomes which are relevant to the concerns of patients. The goals of this study were to compare health-related quality of life and stress level among allergy, healthy and other-diseases groups, and also to compare the relationship of health-related quality of life and stress. METHOD: The study group consisted of 129 subjects with allergy, 139 healthy subjects and 68 subjects with other-diseases. The allergy group was divided into two sub groups: pure allergy group(65) and allergy group with other diseases(64). They completed a questionnaire measuring perceived health-related quality of life, stress and demographic characteristics. The health-related quality of life score was measured by Notingham Health Profile and the stress level was measured by Ok-Suk Lee's instrument. RESULTS: (1) In allergy group with other diseases, the total scores of health-related quality of life were significantly higher than for healthy, pure allergy and other-diseases groups. The results indicated that the perceived health-related quality of life of allergy group with other diseases was in the lowest status among the four groups. (2) Forty-two percent of allergy group with other diseases were in need of treatment for stress level. (3) Level of stress and scores of health-related quality of life have shared linear correlation in healthy and allergy group; higher stress indicates lower status in the quality of life for both groups. CONCLUSION: This study was examined the QOL and the stress level of allergy subjects. When compared with healthy and other-diseases groups, the scores of QOL and the level of stress of the pure allergy group were higher than those of the healthy group, and those of the allergy group with other diseases were also significantly higher than those of the other-diseases group. These results suggest a necessity for futher assessment to improve the QOL and to reduce the stress in allergy subjects.
Humans ; Hypersensitivity* ; Quality of Life* ; Surveys and Questionnaires

Endovascular stenting is accepted as an effective treatment for patients with Budd-Chiari syndrome (BCS). We herein present a case of successful endovascular treatment. A 46-year-old woman, who was followed up for 10 years after a diagnosis of BCS, showed progression progressive of liver cirrhosis and deterioration deteriorated of liver function. Three main hepatic veins were thrombosed with complete occlusion of the suprahepatic of the inferior vena cava (IVC); thus, hepatic venous blood flow was draining into the inferior right hepatic veins through the intrahepatic collaterals and passed passing through the subcutaneous venous collaterals. She underwent endovascular stenting of the IVC for palliation. A septoplasty needle was passed through the occluded IVC through into the internal jugular vein access and then to access the femoral vein using a snare wire. Severe elastic recoiling was observed after balloon dilatation; thus, a 28x80 mm stenting was done inserted across the occlusion, and repeat double ballooning was performed. The final venogram shows showed restored IVC inflow. The patient began to lose body weight 1 day after stenting, and edema disappeared within 1 week. She is was doing well at the 6 month follow-up visit with nearly normal liver function and marked resolution of cutaneous venous engorgement. In conclusion, endovascular stenting appeared to be an effective treatment to alleviate portal pressure and to prevent BCS-associated complications; thus, endovascular stenting should be considered before marked hepatic vein stenosis or complete occlusion occurs in patients with BCS.
Body Weight ; Budd-Chiari Syndrome* ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Edema ; Female ; Femoral Vein ; Follow-Up Studies ; Hepatic Veins ; Humans ; Hyperemia ; Jugular Veins ; Liver ; Liver Cirrhosis ; Middle Aged ; Needles ; Portal Pressure ; SNARE Proteins ; Stents* ; Vena Cava, Inferior*

The biological interpretation of two-dimensional (2D) gel electrophoresis experiments is a key step toward understanding the functions of biological systems. We here present a web-based integrated database, called 2DSpotDB, for the management of proteome data derived from several pathogens. The 2DSpotDB was established as a part of the management of a pathogen proteome project at the Korea National Institute of Health. The goals of the 2DSpotDB implementation are to store and define important pathogen genes, retrieve information obtained by 2D polyacrylamide gel electrophoresis and mass spectrometry, and create an integrated system to provide pathogen proteome information for biological scientists. This database currently contains 14 gels and information on 387 protein spots, among which 329 proteins were identified and annotated.
Acrylic Resins ; Data Mining ; Electrophoresis ; Electrophoresis, Gel, Two-Dimensional ; Electrophoresis, Polyacrylamide Gel ; Gels ; Korea ; Mass Spectrometry ; Proteins ; Proteome

BACKGROUNDS/AIMS: Open surgery for choledochal cyst has a disadvantage of skin incision scar from operative wound, which can be a definite disadvantage especially in young female patients. This study focused on the cosmetic aspect of skin incision for resection of choledochal cyst in young female patients. METHODS: During a 2-year study period, 11 adult female patients aged less than 40 years underwent primary resection of choledochal cyst by a single surgeon. The cosmetic effect of two types of skin incision was evaluated. RESULTS: The patients underwent mini-laparotomy through either a right subcostal incision (n=8) or an upper midline incision (n=3). The mean length of skin incision was 10 cm for right subcostal incisions and 9 cm for upper midline incisions. It took approximately 1 hour to repair the operative wound meticulously in both groups. At the 6 month to 1 year follow-up, a slight bulge on the skin scar was observed in 3 (37.5%) patients of the right subcostal incision group and 1 (33.3%) patient of the upper midline incision group. CONCLUSIONS: The results of this preliminary study support the claim that cosmetic effect of the upper midline incision for CCD surgery appears to be non-inferior to that of the right subcostal incision if the incision is placed accurately and repaired very meticulously.
Adult ; Choledochal Cyst* ; Cicatrix ; Female* ; Follow-Up Studies ; Humans ; Skin* ; Wounds and Injuries