No abstract available.
Myelodysplastic Syndromes* ; Neutrophils* ; Pyoderma Gangrenosum* ; Pyoderma*

The authors report two unusual tumors detected in the right scapula and around left aciatic nerve. Although fibromatosis is benign tumor, the nature is notorious for an aggreasive clinical couras with a tendency to recur in high percentage. Recently we have encountered two instances of fibromatosis, and presented with abort discussion of the clinical pathologic aspects with some review in literatures.
Fibroma ; Scapula

Papineau's technique represents an excellent method of dealing with serious bone infections with significant bone and soft tissue loss. The procedure is carried out in three stages: the 1st stage is the excision of infected bone and soft tissue, stabilization of the fracture site, the 2nd stage is the cancellous bone grafting, and the 3rd stage is the skin coverage. During the period from June 1980 to September 1982, our limited experience with 14 cases has been extremely satisfactory; 1. This method is applicable to traumatic osteomyelitis and some cases in which the infection has been blood borne. 2. Successful bone grafting in the presence of infection depends upon; a. complete sequestrectomy and removal of all infected tissue b. an adequate vascular bed for the graft c. no dead space d. sufficient immobilization.
Bone Transplantation ; Immobilization ; Methods ; Osteomyelitis ; Skin ; Transplants

BACKGROUND: Hereditary spherocytosis(HS) is a clinically and biochemically very heterogeneous disorder The purpose of this study is to detect erythrocyte membrane protein abnormalities by SDS-PAGE and to investigate the frequency of erythrocyte membrane protein defects in hereditary spherocytosis and correlation between some of the hereditary spherocytosis biochemical subsets and the selected clinical phenotype. METHODS: We evaluated the clinical and laboratory characteristics of 14 normal healthy persons and 23 hereditary spherocytosis patients and 8 their family members. The patients were divided into three groups based on clinical and hematological severity(mild, typical, severe). In addition to routine hematologic determlnatlons, osmotic fragility and autohemolysis, RBC membrane protein analysis were performed in all patients by densitometric tracing of SDS-PAGE(sodium dodecyl sulphate polyacrylamide gel electrophoresis) stained by Coomassle blue utilizing both the discontinuous buffer system of Laemmli with acrylamide linear gradient from 4% to 12% and the continuous buffer system of Fairbank with exponential gradient of acrylamide from 3.5% to 17%. RESULTS: 1) The patients could be seperated into three classes of different clinical severity as mild(3 cases), moderate(16 cases) and severe(4 cases) on the clinical feature. 2) Eighteen patients(82.6%) among 23 hereditary spherocytosis revealed abnormal erythrocyte membrane protein and we detected six patients(26.1%) with spectrin deficiency combined with ankyrin reduction, 4 patients(17.4%) with ankyrin deficiency, 4 patients(17.4%) with isolated spectrin deficiency and 3 patients(13.0%) with band 3 deficiency. Five HS patients(21.7%) showed normal RBC membrane protein. 3) Eight HS and their family members showed same RBC membrane protein deficiency. 4) The type and degree of RBC membrane protein reduction were variale with spectrin at 66~94%, with ankyrin at 48~82% of normal levels. These showed that each patient had different clinical severities according to different RBC membrane protein levels and type. CONCLUSION: RBC membrane protein abnormalities were observed in 82.6% of HS patients. The combined spectrin and ankyrin deficiency is the most common molecular defect in HS. The clinical severity and biochemical expression is heterogeneous. SDS-PAGE analysis of RBC membrane protein was provided the diagnosis of RBC membrane defects and basic molecular studies. We believed that the early identification of the biochemical defect responsible for HS is important because it is helpful starling point for the identification of the primary molecular defect, and it could help to anticipate the clinical outcome of the disease. For these reasons, we consider the SDS-PAGE of the red cell membrane to be of crucial importance for a complete evaluation of children with HS. Further studies with more cases would be to clarify the correlation between clinical and biochemical phenotypes.
Acrylamide ; Ankyrins ; Cell Membrane ; Child ; Diagnosis ; Electrophoresis, Polyacrylamide Gel* ; Erythrocyte Membrane* ; Erythrocytes* ; Erythrocytes, Abnormal ; Humans ; Membrane Proteins ; Membranes ; Osmotic Fragility ; Phenotype ; Population Characteristics* ; Spectrin ; Starlings

BACKGROUND: Long-chain triglyceride/medium-chain triglyceride (LCT/MCT) propofol is less painful than standard long chain triglyceride (LCT) propofol; however, there is still a need to reduce severe pain. 5-Hydroxytryptamine type 3 (5-HT3) receptor antagonists have an analgesic effect during the injection of standard LCT propofol. This study compared the incidence of moderate-to-severe injection pain with LCT/MCT propofol using pretreatment with palonosetron versus pretreatment with saline or lidocaine. METHODS: This prospective, randomized double-blind study divided 98 patients scheduled for general anesthesia into three groups: control (n = 33), palonosetron (n = 32), and lidocaine (n = 33) groups. An 18-gauge intravenous catheter was inserted into the peripheral vein at the dorsum of the hand. The patient's vein was occluded by a rubber tourniquet at mid-forearm, and we then administered 2 ml of the pretreatment drug. One minute after venous occlusion, we released the tourniquet and administered LCT/MCT propofol 2 mg/kg for 10-15 seconds. The degree of pain on propofol injection was evaluated using a 4-point scale. RESULTS: The incidence of moderate-to-severe pain in the control, palonosetron, and lidocaine groups was 9.1, 15.6, and 12.1%, respectively. The incidence of overall pain was lower in the lidocaine group than in the control or palonosetron group. CONCLUSIONS: Palonosetron and lidocaine pretreatment does not reduce moderate-to-severe pain on injection of 1% LCT/MCT propofol. Lidocaine pretreatment reduced the overall incidence of injection pain.
Anesthesia, General ; Catheters ; Double-Blind Method ; Hand ; Humans ; Incidence ; Lidocaine* ; Propofol* ; Prospective Studies ; Rubber ; Serotonin ; Tourniquets ; Triglycerides ; Veins

PURPOSE: To clarify the distribution of joint effusion, and the relationship between type of injury andamount of joint effusion seen in traumatic knee joint magnetic resonance imaging (MRI). MATERIALS AND METHODS: Weretrospectively reviewed the MR images of 400 patients with traumatic knee joint effusion. The knee joint spacewas divided into four compartments: central portion (para-ACL, para-PCL), suprapatellar pouch, posterior femoralrecess, and subpopliteal recess, and we then compared the amount and distribution of effusion. For statisticalanalysis, the chi-square test was used. RESULTS: Among 400 MRI examinations of joint effusion, 383 knees (96%)showed homogeneous low intensity on T1-weighted images, and - except for ten cases of fluid-fluid levels-homogeneous high intensity on T2-weighted images. Knee joint effusion was clearly shown to be distributed mainlyin the suprapatellar pouch (345, 86%), followed by the central posterior femoral recess, and the subpoplitealrecess (p<0.001). Extensive joint effusion was less frequently found in the normal group, but was occasionallyfound in the combined injury group (p<0.001). The relationship between amount of joint effusion and type ofinjury was statistically significant (p<0.001), except in the case of medial and lateral collateral ligamentinjury. CONCLUSIONS: The distribution of joint effusion in patients with traumatic knee disorders is a reflectionof anatomic communication, and whether the amount of joint effusion was small or large depended on the anatomicallocation and type of injury.
Humans ; Joints* ; Knee Joint* ; Knee* ; Magnetic Resonance Imaging

We present a patient with ischemic lumbar plexopathy due to unilateral obstruction of iliolumbar artery, a branch of internal iliac artery. Although most parts of lumbar plexus and femoral nerve have rich vascularization and therefore are resistant to ischemic injury, but their poorly vascularized intrapelvic portions are vulnerable to ischeniic insults caused by stenosis or obstruction of internal iliac artery and/or its branch. So in lumbar plexopathy, angiograhpy with many other extensive examinations shoud be recommended for differentiation from various causes.
Arteries* ; Constriction, Pathologic ; Femoral Nerve ; Humans ; Iliac Artery ; Lumbosacral Plexus

Osseointegrated implants have been established as the standard treatment modality for full/partial edentulous patients since the 1960's, and the long term results for full edentulous patients have proven to be successful. Based on these results osseointegrated implants are now widely used for partial edentulous patients. There has been an increased interest towards the efficacy of wide implants, despite many reports mentioning the lower success rate of wide implants compared to regular implants. Recently, mandibular molar area defects are commonly restored using 2 wide implants, but it is not determined whether which treatment modality-3 regular implants or 2 wide implants-shows superior success rate. In this study, 2 wide implants and 3 regular implants used for the restoration of mandibular molar area are used to compare the survival rate of 1-4 years, and to analyze and compare the failure factors. The following conclusions could be drawn from this study. 1. Wide implants and regular implants showed 94.5% and 97,6% of survival rate respectively. After prosthodontic work, the survival rate was 100% and 98.1% for wide implants and regular implants respectively. 2. 5 failed implants have been removed. 2 wide implants and 1 regular implant have been removed due to failure of osseointegration, 1 wide implant was removed due to abscess formation caused by over-heating, and 1 regular implant was removed due to mechanical failure caused by over-loading within the first year of function. 3. No statistically significant difference was observed with respect to the amount of marginal bone loss of wide and regular implants.(P>0.05) In conclusion, restoration of the mandibular molar area using 3 regular implants was found to be a good treatment modality, and 2 wide implants could be considered a good treatment modality when success factors are taken into account.
Abscess ; Humans ; Molar ; Osseointegration ; Prosthodontics ; Survival Rate

PURPOSE: Konkuk University Hospital (KUH), which opened in September 2005, is currently categorized as a secondary hospital. Early on after its establishment, the surgical residents and nurses were relatively inexperienced in the treatment of stomach cancer. Therefore, the quality of surgery for stomach cancer at KUH may be different from that of the existing large-scale tertiary hospitals. The purpose of this study is first to investigate the clinicopathological characteristics of the gastric cancer patients at the KUH, and second to compare our morbidity & mortality rates with those of previous studies, and we also analyzed the risk factors of morbidity at the early stage of a training hospital. MATERIALS AND METHODS: This study retrospectively collected the clinicopathological characteristics and the post-operative morbidity rates and mortality rates with using the electronic medical records of all the patients who went under a gastric cancer operation at KUH from September 2005 to April 2008. RESULTS: The total number of gastric cancer patients who underwent operation was 201. The morbidity rate and death rate at KUH were 10.4% and 0.5%, respectively. The morbidity has increased with an older age. The other variables had no influence on morbidity. CONCLUSION: The morbidity rate, death rate and the clinicopathological characteristics of gastric cancer patients at KUH were similar to those of the previous reports. We found that age is the main factor affecting the morbidity rate after stomach cancer surgery. For further surgical qualification of stomach cancer surgery at KUH, it is necessary to collect the survival data of patients who undergo stomach cancer surgery.
Electronic Health Records ; Humans ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; Tertiary Care Centers

BACKGROUND: The changes in acid-base balance and serum electrolytes after infusion of 0.9% normal saline during renal transplantation are poorly characterized. In this study, the relationships between the infusion of fluids and the changes in arterial blood gas analysis, serum electrolytes and central venous pressure during renal transplantation were determined. METHODS: Sixty-seven patients undergoing elective renal transplantation were divided into two groups: group I (n = 33) was made up of patients who received a living related renal transplantation, while group II (n = 34) was made up of those who received a living unrelated renal transplantation. Blood gas analysis, central venous pressure and serum electrolytes were evaluated just after the beginning of the operation, just before reperfusion (unclamping of the renal artery and vein), just after reperfusion and 20 minutes after arriving in the recovery room. RESULTS: pH, base excess, HCO3 and Na+ concentration were decreased, but PaCO2 was not changed during the operation. Central venous pressure and K+ concentrations were elevated during the operation. CONCLUSIONS: The results of this study suggest that 0.9% normal saline and mannitol leads to dilutional acidosis. If a lot of fluids are required during transplantation, we need to consider that 0.9% normal saline can aggravate acidosis in a renal transplantation patient.
Acid-Base Equilibrium ; Acidosis ; Blood Gas Analysis* ; Central Venous Pressure* ; Electrolytes* ; Humans ; Hydrogen-Ion Concentration ; Kidney Transplantation* ; Mannitol ; Recovery Room ; Renal Artery ; Reperfusion