The zinc finger protein ZBTB48 is a telomere-associated factor and renamed it as telomeric zinc finger-associated protein (TZAP). It binds preferentially to long telomeres competing with TRF1 and TRF2. However, its mutation in cancers has not been studied. In the present study, we analyzed TZAP mutation in 134 non-small cell lung cancers (NSCLCs). And its big data analysis was performed using COSMIC and TCGA data analysis. TZAP mutation was not found in 134 NSCLCs. And big data also showed that TZAP mutation was extremely low (0.59%, 15/2548). TCGA survival analysis showed no prognostic value of TZAP expression in lung adenocarcinoma (p = 0.185) and squamous cell carcinoma (p = 0.817). When stratified patients sorting as 25:25 (quarter), it has a significance (p = 0.003). This result suggested that genetic change of TZAP did not appear to be a possible molecular marker in lung cancer.

473 patients who underwent orthopedic surgery of the upper extremities from July 1978 to August 1983 were studied and the results are as follows. 1) Among 473 patients 294 patients given general anesthesis. Axillary brachial piexus block(141 cases), intraveonus regional anesthesia(10 cases), interscalene block(2 cases) and continuous brachial plexus block were given to the rest of the patients. 2) 267 patients were male and 106 patients were female. Age distribution was from 2 to 74 years. 3) Physical status of the patients was A.S.A. (American Society of Anesthesiologists) class 2(52.5%), class 1(43.4%), class 3(4.4%) in the order. 47.2% of the patients underwent emergency operation. 4) There was a tendency that regional anesthesis has been increasing year by year. 5) The type of operations were open reduction(160cases), tendon repair(112cases), and surgery for neuropathy(65 cases). 6) The operations for upper arm, elbow, and forearm were performed mostly under general anesthesia, while regional anesthesia prevailled for hand, wrist, and digits operations. 7) Brachial plexus block was considered as a method of choice for upper extremity surgery, especially for emergency surgical procedures in patients with significant medical problems. 8) A new method was tried in which a flexible disaposable intravenous catheter was introduced into the neurovascular sheath in the axilla and used for injection of local anesthetic solutions to block the axillary brachial plexus. The catheter method constitutes an interesting alternative to the conventional needle techniques and offers a continuous axillary block and a method for postoperative pain relief.
Age Distribution ; Anesthesia, Conduction ; Anesthesia, General ; Arm ; Axilla ; Brachial Plexus ; Catheters ; Elbow ; Emergencies ; Female ; Forearm ; Hand ; Humans ; Male ; Needles ; Orthopedics ; Pain, Postoperative ; Tendons ; Upper Extremity* ; Wrist

BACKGROUND: The treatment strategy for primary spontaneous pneumothorax has progressively changed with the introduction of video-assisted thoracic surgery (VATS). Recently, we modified the strategy of primary spontaneous pneumothorax. If the patient had mild dyspnea and the lung was minimally collapsed, 2 mm thoracoscopic examination was performed. If no bleb or bullae was inspected, the intrathoracic air was evacuated through the 2 mm thoracoscopic troca without closed thoracostomy. and if the bleb and bullae was noted, the 10 mm thoracoscopic bullecotomy was carried out immediately and also application of fibrin glue was substituted for pleural abrasion. We compared the clinical outcomes of modified treatment strategy with conventional strategy in primary spontaneous pneumothorax. MATERIAL ANDMETHOD: Patients were divided into four groups. Group I (n=21) underwenet 2 mm thoracoscopic examination. Group II (n=68) underwent closed thoracostomy. Group III (n=56) underwent VATS and application of fibrin glue. Group IV (n=87) underwent VATS and pleural abrasion. The duration of chest tube drainage, the duration of hospitalization and the recurrence rate were compared between group I and group II and between group III and group IV. RESULT: Mean age, sex, location of pneumothorax were not different in all groups. In group I, the bleb or bullae were existed in 12 patients. In remaining 9 patients, the bleb or bullae was not inspected. The mean duration of hospitalization in 9 patients were 2.1+/-1.0 day and in group II were 3.9+/-2.1 day (p=0.014). There was 1 case of recurrence among the 9 patients in group I and 26 recurrences in group II (p=0.149). The mean duration of chest tube drainage were not difference in group III and IV (group III: 2.8+/-1.8 day, group IV: 3.0+/-2.5 day). The mean duration of hospitalization was shorter in group III than group IV (group III: 5.6+/-2.7 day, group IV: 7.3+/-3.3 day)(p=0.002). There was no recurrence in group III and 7 recurrences in group IV (p=0.043). CONCLUSION: Our modified treatmen strategy of primary spnontaneuous peumothorax was effective in short hospital course and low recurrence rate.
Blister ; Chest Tubes ; Drainage ; Dyspnea ; Fibrin Tissue Adhesive* ; Fibrin* ; Hospitalization ; Humans ; Lung ; Pneumothorax* ; Recurrence ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracostomy

Thirteen patients were operated for cubital tunnel syndrome and followed for an average of 26 months postoperatively. Ten patients had a history of relevant trauma and three patients had degenerative osteoarthritis of the elbow. The average duration of symptoms was 18 months (range, 2 to 96 months). Diagnosis was made by physical examination, electromyography and nerve conduction study. Among these, nerve conduction study was found to be the most valuable diagnostic method for the patients with atypical clinical findings. Most of the operations were performed by anterior transposition of the ulnar nerve. At the most recent follow-up, the result was excellent in two patients, good in eight, and fair in three; thus ten patients(77%) showed satisfactory results. The rating system for ulnar neuropathy based on sensory, motor dysfunction and pain was useful for evaluating the operative results. The postoperative gain of score for pain and sensory function were larger than that of motor function. Factors known to influence the result of the operation (age, duration of symptom, history of trauma, method of operation) did not effect the outcome in this study. For successful operation, the ulnar nerve must be thoroughly examined, all possible levels of compression must be released and new foci of compression must be created.
Cubital Tunnel Syndrome ; Diagnosis ; Elbow ; Electromyography ; Follow-Up Studies ; Humans ; Methods ; Neural Conduction ; Osteoarthritis ; Physical Examination ; Sensation ; Ulnar Nerve ; Ulnar Neuropathies

Extensive tumoral calcinosis affecting a large joint is uncommon in patients with systemic sclerosis. We report the case of a 52-year-old female patient referred for a growing calcified mass in the shoulder. She was diagnosed with interstitial lung disease and progressive systemic sclerosis. Although the pain and disability associated with the affected joint was not severe, the patient underwent surgical excision because the mass continued to grow and was likely to produce shoulder dysfunction and skin ulceration. The patient appeared well 10 months after surgery with no signs of recurrence. This report highlights the timing and indication of surgical excision in similar cases.
Calcinosis* ; Female ; Humans ; Joints ; Lung Diseases, Interstitial ; Middle Aged ; Quality of Life ; Recurrence ; Scleroderma, Diffuse ; Scleroderma, Systemic* ; Shoulder ; Skin Ulcer

Spontaneous pneumomediastinum is a very uncommon entity that is defined as the presence of free air in the mediastinum without an obvious etiology. The presence of air in the spinal canal, known as concurrent pneumorrhachis, is an extremely rare epiphenomenon of spontaneous pneumomediastinum. We report a rare case of spontaneous pneumomediastinum with pneumorrhachis associated with influenza. The patient was diagnosed without invasive procedures, was managed with supportive treatment, and recovered without any complications.
Humans ; Influenza, Human ; Mediastinal Emphysema* ; Mediastinum ; Pneumorrhachis* ; Spinal Canal

Schwannomas of the brachial plexus are rare. Although the tumor size is small, neurological symptoms occur due to the mass effect of the tumor within the brachial plexus. In our case, the patient did not recognize the symptoms until the tumor diameter increased to 10 cm because the mass was located at the inferior border of the brachial plexus and had grown up to the chest wall. The mass was identified at the medial cord of the right brachial plexus arising from the C8 and T1 origin. A complete excision was performed. The patient recovered without any neurologic symptoms.
Brachial Plexus ; Humans ; Neurilemmoma* ; Neurologic Manifestations ; Thoracic Wall

Thoracic outlet syndrome (TOS) is a condition related to compression of neurovascular structures within the thoracic outlet. Several surgical approaches are used to treat TOS, and the selection of the approach depends on the type of TOS. Our patient was diagnosed with vascular TOS and resection of the first rib was performed using the infraclavicular approach. The patient did not experience any perioperative complications, and there was no sign of recurrence at the 1-year follow-up. The infraclavicular approach is a suitable method for first rib resection in patients with vascular TOS.
Follow-Up Studies ; Humans ; Recurrence ; Ribs* ; Thoracic Outlet Syndrome*

Metronidazole-induced encephalopathy (MIE) can be caused by excessive dose or prolonged metronidazole administration. The signal abnormalities in the cerebellar dentate nuclei, midbrain, dorsal pons and corpus callosum on magnetic resonance imaging are considered as the characteristic feature of MIE. Although the mechanism of MIE remains to be elucidated, various hypothesis have been proposed including the role of metronidazole as a thiamine antagonist. Here we report a 58-year-old woman with MIE who coincidentally presented with thiamine deficiency.
Brain Diseases ; Corpus Callosum ; Female ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Metronidazole ; Middle Aged ; Pons ; Thiamine Deficiency ; Thiamine

A 44-year-old man had been admitted for dyspnea on exertion and abdominal distension. The echocardiography revealed abnormal mass in right atrium and tricuspid valve stenosis with right ventricular obliteration. The operation was performed with mass removal, enlargement of tricuspid valve opening, and right ventricular endocardiectomy. And then, atrial septal defect was made due to inadequate right ventricular volume. The patient's symptom was improved and he discharged without events. The endomyocardial fibrosis was diagnosed with microscopic examination. Eighteen months later, the patient was readmitted due to aggravated dyspnea and cyanosis. The right ventricular obliteration was progressed and pulmonary blood flow was severely decreased in follow up echocardiography. Palliative bidirectional cavo-pulmonary shunt was performed due to functional single ventricle. The dyspnea and cyanosis was markedly improved. Bidirectional cavo-pulmonary shunt for advanced and isolated right ventricular endomyocardial fibrosis provided effective palliation at early postoperative period, However, long-term follow up is mandatory.
Adult ; Cyanosis ; Dyspnea ; Echocardiography ; Endomyocardial Fibrosis* ; Follow-Up Studies ; Fontan Procedure* ; Heart Atria ; Heart Septal Defects, Atrial ; Humans ; Postoperative Period ; Tricuspid Valve ; Tricuspid Valve Stenosis