No abstract available.
Gallium* ; Neoplasm, Residual* ; Wounds and Injuries*

Cryptococcosis is a systemic opportunistic infection mostly occurred in immunosuppressed patients. Pulmonary cryptococcosis in immunocompetent host is usually localized and self-limiting disease. Pulmonary nodule or mass is the most common radiologic finding, however involvement of mediastinal lymph nodes is rare. Here we report a case of pulmonary cryptococcosis with massive mediastinal lymph nodes involvement in immunocompetent host.
Cryptococcosis* ; Humans ; Lymph Nodes* ; Opportunistic Infections ; Pneumonia

Background: We recently introduced the Barricor (BD, Franklin Lakes, NJ, USA) plasma separation tube, which uses a mechanical separator instead of a gel. We evaluated the effects of using the Barricor tube in a stat (statin) laboratory on the results and turnaround time (TAT) of routine chemical tests. We verified the impact of Barricor tube on reducing TAT and providing results similar to those obtained using serum separator tubes (SSTs). Methods: We collected venous blood samples from 166 outpatients in Barricor tubes and SSTs and measured 28 routine analytes using an AU5800 instrument (Beckman Coulter, Brea, CA, USA). TAT indexes were compared before and after using Barricor tube. Results: Mean percent differences were < 5%, except for alanine aminotransferase , total CO2, high-density lipoprotein, phosphate, total protein, and direct bilirubin. The median TAT decreased from 45 to 38 minutes, and the rate of a TAT > 60 minutes decreased from 7.84% to 2.66%, which was approximately one-third of that for SST. The reduction in TAT was attributable to a decrease in centrifugation time. Incomplete clotting and repeated centrifugation, which occurred frequently when using SST, also decreased after using the Barricor tubes. Conclusions The Barricor tube is an alternative to SST for routine chemical tests in institutions aiming to reduce TAT, with clinically allowable differences in test results.

Purpose: This study morphologically compared and analyzed various measurements from initial radiograph and computed tomography scans of posterior malleolar fractures (PMFs) in tibial spiral fractures and ankle fractures. Materials and Methods: The measurements of PMFs in 31 TSFs and 53 AFs were analyzed. PMFs were classified using Bartoníček’s classification. The initial displacement (ID), cross angle (CA), fragment length ratio (FLR), fragment width ratio (FWR), fragment height ratio (FHR), fragment height (FH), sagittal angle (SA), articular step-off (AS), and inter-fragment distance (IFD) were measured. The presence of intercalary fragments and articular incongruity were identified. Results: Bartoníček types 2 and 3 in the AF group, type 3 in the supination-external rotation (SER) group, type 2 in the pronation-external rotation (PER) group, and type 4 in the TSF group accounted for the largest proportion. In the TSF group, the mean ID, FWR, SA, AS, and IFD were significantly smaller than in the AF group (p<0.001, p=0.003, p<0.001, p<0.001, and p<0.001, respectively). The CA, FLR, FH, and FHR were significantly larger than the AF group (p<0.001, p=0.019, p<0.001, and p<0.001, respectively). Conclusion In TSFs, posterior malleolar fragments tend to have longer anteroposterior lengths and heights, but shorter horizontal lengths than AFs. Most have minimal displacement, congruous joint, and no intercalary fragments. Understanding these morphological differences is necessary for the clinical approach to PMFs in TSFs and AFs.

Purpose: This study examined the outcomes of additional medial locking plate fixation and autogenous bone grafting in the treatment of nonunions that occurred after initial fixation for distal femoral fractures using lateral locking plates. Materials and Methods: The study involved eleven patients who initially underwent minimally invasive lateral locking plate fixation for distal femoral fractures between January 2008 and December 2020. The initial procedure was followed by additional medial locking plate fixation and autogenous bone grafting for clinically and radiographically confirmed nonunions, while leaving the stable lateral locking plate in situ. A clinical evaluation of the bone union time, knee joint range of motion, visual analog scale (VAS) pain scores, presence of postoperative complications, and functional evaluations using the lower extremity functional scale (LEFS) were performed. Results: In all cases, bone union was achieved in an average of 6.1 months after the secondary surgery. The range of knee joint motion, weight-bearing ability, and VAS and LEFS scores improved at the final follow-up compared to the preoperative conditions. All patients could walk without walking assistive devices and did not experience pain at the fracture site. On the other hand, three patients complained of pain in the lateral knee joint caused by irritation by the lateral locking plate; hence, lateral hardware removal was performed. One patient complained of mild paresthesia at the anteromedial incision site.Severe complications, such as deep infection or metal failure, were not observed. Conclusion For nonunion with stable lateral locking plates after minimally invasive lateral locking plate fixation of distal femur fractures, additional medial locking plate fixation and autogenous bone grafting, while leaving the lateral locking plate intact, can achieve successful bone union.