No abstract available.
Korea* ; Lung Neoplasms* ; Lung*

No abstract available.
Diagnosis, Differential*

Proliferative scarring in the form of keloids and hypertrophic scars continues to be a clinical problem for some patients. The lack of an animal model for such scarring has been an obstacle to studying the biology and effective therapy of these entities. Consequently we created an accurate reproductive animal model to systematically study them. Human proliferative scars were explanted into flaps based on isolated vascular pedicles in congenitally rats. We compared the procollagen type III peptide levels of proliferative scar tissue before and after explanting. The procollagen type III peptide levels of explanted proliferative scar tissue remained increased as before explanting. Histological analysis of the explanted proliferative scar tissue revealed that all explants retained their original histotypic character even after 1 year. We could also retain the volume of implanted proliferative scar for 1 year and studied in vitro cellular proliferation. Fibroblast cultures from explanted scars demonstrated less aggressive growth characteristic than those from original surgical specimens. The advantages of this animal model are as follows: 1. The explants retain their histotypical character for a long period. 2. Placement of the explants outside the dorsum of a nude rat makes serial observation and measurement easier. 3. Agents under test can be injected into the explants through a catheter inserted into a single pedicle of island flap without the possibility of spreading systematically.
Animals* ; Biology ; Catheters ; Cell Proliferation ; Cicatrix* ; Cicatrix, Hypertrophic ; Collagen Type III ; Fibroblasts ; Humans ; Keloid ; Models, Animal* ; Rats ; Rats, Nude

PURPOSE: To determine clinical and radiographic results of iliac bone grafting with Kirschner wire fixation for treatment of scaphoid nonunions. METHODS: A total of 13 patients who had scaphoid nonunion treated with iliac bone grafting and Kirschner wire fixation between October 2007 and January 2016 were enrolled as subjects of this study. Their clinical results were evaluated, including range of motion of the wrist joint and modified Mayo wrist score. Radiographic results including lateral intrascaphoid angle and scapholunate angle were also assessed. RESULTS: Bony union was achieved in 11 (84.6%) of 13 cases. Modified Mayo wrist score was improved from 64.0 preoperatively to 87.5 postoperatively. Average intrascaphoid angle was improved from 39.5° preoperatively to 27.2° postoperatively while scapholunate angle was improved from 66.0° preoperatively to 55.1° postoperatively. CONCLUSION: Iliac bone graft with Kirschner wire fixation provided good clinical and radiographic results. Therefore, iliac bone graft with Kirschner wire fixation can be considered as a good treatment option for scaphoid nonunion.
Bone Transplantation ; Humans ; Range of Motion, Articular ; Transplants* ; Wrist ; Wrist Joint

OBJECTIVE: Immediate contralateral epidural hematoma (EDH) and traumatic intracerebral hematoma (T-ICH) after craniectomy for traumatic subdural hematoma (SDH) are rare but devastating post-operative complications. Their clinical features and outcomes are not well studied. In this report, we present the clinical features and outcomes of immediate contralateral acute hematoma cases requiring a second operation. METHODS: This study includes 10 cases of immediate contralateral EDH and T-ICH following bilateral craniectomy for the evacuation of traumatic SDH and contralateral hematoma between 2004 and 2015. Their medical records and radiographic findings were reviewed and analyzed retrospectively. RESULTS: Ten of the 528 patients (1.89%) who underwent craniectomy for the evacuation of traumatic SDH developed post-operative EDH (n=5), T-ICH (n=5). The trauma was caused by a fall in 5 patients and by a traffic accident in 5 patients. The patients who suffered trauma due to pedestrian accidents died. Seven patients had a low admission Glasgow Coma Scale (GCS; GCS≤8) score in the preoperative state (average admission GCS, 7.7; average discharge GCS, 3.4; and average discharge Glasgow Outcome Scale, 2.0). Severe intra-operative brain swelling was noted in all patients, while skull fracture was observed in 8. Multiple associated injuries and medication for heart disease were characteristic of patients who died. CONCLUSION: The prognosis of delayed contralateral hematoma was very poor. Multiple associated injuries, past medical history and traffic accidents, especially pedestrians were seemed to be associated with higher mortality rates. Finally, contralateral skull fractures can indicate high risk of delayed contralateral acute intracranial hematoma.
Accidents, Traffic ; Brain Edema ; Decompression* ; Decompressive Craniectomy ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Heart Diseases ; Hematoma* ; Hematoma, Subdural ; Hematoma, Subdural, Acute* ; Humans ; Medical Records ; Mortality ; Pedestrians ; Prognosis ; Retrospective Studies ; Skull Fractures

We report a case of acute cerebral infarction after general anesthesia. A 55-year-old man underwent total gastrectomy and splenectomy for advanced gastric cancer. Preoperatively, he has complained headache and dizziness for a year but neurologist, internist and anesthesiologist could not find any sign of cerebrovascular diseases. General anesthesia was induced with thiopental and maintained with 50% N2O and 1.5-2% enflurane in oxygen. After approximately 4h in the recovery room, he was not regained his consciousness. On physical examination, there was right hemiplegia. Immediate brain CT revealed acute cerebral infarction in left MCA and ACA territory. He was transported SICU. The following day he had a carotid Doppler ultrasonography that showed complete obstruction of both ICA. Neurologic examination showed negative eye reflex and pupil full dilation. He was discharged in a hopeless situation.
Anesthesia, General* ; Brain ; Cerebral Infarction* ; Consciousness ; Dizziness ; Enflurane ; Gastrectomy ; Headache ; Hemiplegia ; Humans ; Middle Aged ; Neurologic Examination ; Oxygen ; Physical Examination ; Pupil ; Recovery Room ; Reflex ; Splenectomy ; Stomach Neoplasms ; Thiopental ; Ultrasonography, Doppler

PURPOSE: The aims of this study are to evaluate the outcome of treatment for developmental dislocation of the hip (DDH) in children under the age of 24 months who underwent open reduction (OR) or closed reduction (CR) and to determine radiologic prognostic factor. MATERIALS AND METHODS: A total of 90 hips of 88 children under the age of 24 months treated for DDH were included. The treatments for these children were CR in 29 hips and OR in 61 hips. All patients were followed up for more than 5 years. Radiographic evaluations, including acetabular index (AI), Yamamuro's distance a and b, center-edge angle (CEA), sourcil shape, and teardrop shape have been proposed to indicate the degree of DDH. Hips were reclassified according to the Severin criteria (classes I and II, satisfactory; classes III and IV, unsatisfactory). RESULTS: Among the 90 hips, 67 hips (74.4%) were included in the ‘satisfactory group’, while 23 hips (25.6%) were included in the ‘unsatisfactory group’. In the CR group, 23 hips (79.3%) were included in the ‘satisfactory group’, while 6 hips (20.7%) were included in the ‘unsatisfactory group’. In the OR group, 44 hips (72.1%) were included in the ‘satisfactory group’, while 17 hips (27.9%) were included in the ‘unsatisfactory group’. There was no significant difference between the reduction methods. At 1 year follow-up after reduction, the AI improvement in the ‘satisfactory group’ (8.1° [23.4%]) was significantly higher than that in the ‘unsatisfactory group’ (6.7° [18.5%]) (p=0.012). A significant difference of the mean CEA values was observed between the ‘satisfactory group’ and the ‘unsatisfactory group’ 3 years after the treatment (p=0.001). Five years after reduction, the V shape of teardrop and the upward shape of acetabular sourcil were observed in 2 hips (3.0%) and 4 hips (6.0%) of the ‘satisfactory group’, respectively, whereas the corresponding findings were observed in 3 hips (13.0%) and 5 hips (21.7%) of the ‘unsatisfactory group’, respectively (p=0.023, 0.005). CONCLUSION: The improvement of AI at 1-year and CEA at 3-year follow-ups, as well as teardrop shape and sourcil shape at 5-year followup, were reliable radiographic prognostic factor of DDH.
Acetabulum* ; Child ; Dislocations* ; Follow-Up Studies ; Hip* ; Humans

BACKGROUND AND OBJECTIVES: Electrocardiography (ECG) is a cost-effective and useful method for diagnosing left ventricular hypertrophy (LVH) in a large-scale study or in clinical practice. Among ECG criteria, the Cornell product (Cor P) and Sokolow-Lyon criteria were adopted by the European Society of Hypertension-European Society of Cardiology Guidelines but have different performances among races. The aim of this study was to compare the diagnostic performance of two voltage criteria in Korean patients. SUBJECTS AND METHODS: Electrocardiography and echocardiographic LV mass of 332 (159 male, 173 female) consecutive patients were analyzed. Cornell voltage criteria and the Cor P were compared with Sokolow-Lyon voltage (Sok V) and the Sokolow-Lyon product (Sok P). The sensitivities and specificities were estimated using a receiver-operating characteristics (ROC) curve in relation to the LVH diagnosis. The sensitivities and revised cut-off values were derived at specificity levels of 90, 95, and 100%. RESULTS: The Cornell-based criteria generally showed better performance than that of the Sok V criteria and Sok P in the area under the ROC curve analysis. The revised cut-off values for the Cornell voltage criteria (20 and 16 mm for males and females, respectively) showed an improved sensitivity (19.7 and 30.3% for males and females, respectively), with a high specificity of 95%. CONCLUSION: The Cornell-based criteria had better performance than that of the Sokolow-Lyon criteria in both Korean men and women. However, revised cut-off values are needed to improve accuracy.
Cardiology ; Continental Population Groups ; Echocardiography ; Electrocardiography ; Female ; Humans ; Hypertrophy, Left Ventricular ; Male ; ROC Curve ; Sensitivity and Specificity

Metastatic calcification is rare; it is found during autopsy in patients who underwent hemodialysis. Diffuse calcium precipitation of small and medium-sized cutaneous vessels, known as calciphylaxis, can result in progressive tissue necrosis secondary to vascular calcification. This condition most commonly involves the skin; however, a rare occurrence of visceral calciphylaxis has been reported. Here we report on an autopsy case. Despite a thorough evaluation, and even performing an autopsy, the underlying cause of acute-onset hypercalcemia, resulting in the production of pulmonary calciphylaxis and metastatic renal calcification associated with acute respiratory and renal failure, could not be determined. Metastatic calcification often lacks specific symptoms, and the degree of calcification is a marker of the severity and chronicity of the disease. This unusual autopsy case emphasizes the importance of rapidly progressing visceral calciphylaxis, as well as its early detection.
Autopsy ; Calciphylaxis ; Calcium ; Humans ; Hypercalcemia ; Necrosis ; Renal Dialysis ; Renal Insufficiency ; Vascular Calcification

OBJECTIVE: A general orientation along the cervical spine could be estimated by external landmarks, and it was useful, quick and less exposable to radiation, but, sometimes it gave reference confusion of target cervical level. The authors reviewed the corresponding between the neck external landmarks and cervical levels. METHODS: Totally 1,031 cervical lateral radiographs of different patients were reviewed in single university hospital. Its compositions were 534 of males and 497 females; 86 of second decades (10-19 years-old), 169 of third decades, 159 of fourth decades, 209 of fifth decades, 275 of sixth decades, and 133 of more than seventh decades (>60 years-old). Reference external landmarks (mandible, hyoid bone, thyroid cartilage, and cricothyroid membrane) with compounding factors were reviewed. RESULTS: The reference levels of cervical landmarks were C2.13 with mandible angle, C3.54 with hyoid bone, C5.12 with thyroid cartilage, and C6.01 with cricothyroid membrane. The reference levels of cervical landmarks were differently observed by sex, age, and somatometric measurement (height) accordingly mandible angle from C1 to C3, hyoid bone from disc level of C2 and C3 to C5, thyroid cartilage from disc level of C3 and C4 to C7, and cricothyroid membrane from C4 to disc level of C7 and T1. CONCLUSION: Surface landmarks only provide general reference points, but not correspond to exact levels of the cervical spine. Intraoperative fluoroscopy ensures a more precise placement to the targeted cervical level.
Female ; Fluoroscopy ; Humans ; Hyoid Bone ; Male ; Mandible ; Membranes ; Neck ; Spine* ; Thyroid Cartilage