PURPOSE: The purpose of this study is to evaluate the pronator quadrates muscle in patients who underwent internal fixation with a volar locking plate for unstable distal radius fractures. MATERIALS AND METHODS: Forty patients who underwent internal fixation with a volar locking plate for unstable distal radius fracture were enrolled. We evaluated the clinical results according to the Mayo wrist score, the wrist range of motion, and the grip strength at the last follow-up. Using ultrasonography, muscle thickness of the pronator quadrates was compared between injured and uninjured arm. RESULTS: Bone union was achieved in all cases. The mean Mayo wrist score was 82.79 points. The grip strength of the injured arm was decreased to 89.1% of the uninjured side. The decrease of pronation range of the injured wrist motions was significant (82.3degrees, p=0.004). There was significant atrophy of the pronator quadrates muscle on the injured side (injured side: 3.19 mm, uninjured side: 4.72 mm, p=0.001); and the decrement of muscle thickness in pronator quadrates showed an association with the Mayo wrist score (r=-0.35, p=0.042). CONCLUSION: These results suggest that continuity of the muscle is maintained after use of the volar locking plating for unstable distal radius fractures with repair of pronator quadrates; however, there is atrophy of pronator quadrates muscle and limitation of pronation in the injured wrist.
Arm ; Atrophy ; Follow-Up Studies ; Hand Strength ; Humans ; Pronation ; Radius Fractures* ; Range of Motion, Articular ; Ultrasonography ; Wrist

Hepatocellular carcinoma (HCC) rarely invades the gastrointestinal (GI) tract. It occurs in 0.7% to 2% of clinical HCC cases. Moreover, gastric invasion with GI hemorrhage via peritoneal seeding is very rare. We report the case of 67-year-old woman who had a history of HCC rupture and was admitted due to left upper quadrant abdominal pain. The patient was diagnosed with three omental metastatic masses and underwent hepatic segmentectomy and omental tumorectomy. Two months later, the patient had massive melena, and an esophagogastroduodenoscopy showed very large ulcerated friable mass on the gastric body. The histology was consistent with the diagnosis of metastatic HCC. The patient died from persistent GI hemorrhage 93 days after the admission. This case illustrates the very rare event of peritoneal seeding of a ruptured HCC causing direct invasion of the stomach, followed by GI hemorrhage.
Aged ; Carcinoma, Hepatocellular/*diagnosis/radiography/secondary ; Female ; Gastrointestinal Hemorrhage/*diagnosis/etiology/radiography ; Gastroscopy ; Humans ; Liver Neoplasms/*diagnosis/pathology/radiography ; *Neoplasm Seeding ; Peritoneal Neoplasms/*diagnosis/radiography/secondary ; Stomach Neoplasms/*diagnosis/radiography/secondary ; Tomography, X-Ray Computed

Antineutrophil cytoplasmic antibodies (ANCAs) are now regarded as a serologic marker for pauci-immune crescentic necrotizing glomerulonephritis either in renal-limited form or in association with systemic vasculitis, such as Wegener? granulomatosis, microscopic polyarteritis, and Churg-Strauss syndrome. Two major ANCA antigens have been indentified: proteinase3, which produces a cytoplasmic staining pattern termed C-ANCA, and myeloperoxidase, which produces a perinuclear pattern termed P-ANCA on ethanol-fixed neutrophils by indirect immunofluorescence. In ANCA- associated diseases, eosinphilia in excess of 1.5X109/L has been proposed to be characteristic of Churg-Strauss syndrome and is rare in other forms of ANCA-associated systemic vasculitis and crescentic necrotizing glomerulonephritis. Recently, there were two cases of P-ANCA positive crescentic necrotizing glomerulonephritis with peripheral blood eosinophilia and extrarenal microscopic vasculitis without asthma or granulomas. We experienced a patient with P-ANCA positive pauci-immune necrotizing glomerulonephritis with few eosinophilic infiltration and eosinophilia. He improved with oral prednisolone along with combination of intravenous cyclophosphamide. So we report this case with the review of literature.
Antibodies, Antineutrophil Cytoplasmic* ; Asthma ; Churg-Strauss Syndrome ; Cyclophosphamide ; Cytoplasm ; Eosinophilia* ; Eosinophils ; Fluorescent Antibody Technique, Indirect ; Glomerulonephritis* ; Granuloma ; Humans ; Neutrophils ; Peroxidase ; Prednisolone ; Systemic Vasculitis ; Vasculitis

PURPOSE: To determine the potential of spiral CT as a functional imaging modality of the lung asid from its proven value in morphological depiction. MATERIALS AND METHODS: Spiral CT scan was performed in ten normal female and nine normal male adults (mean age: 39, height: 163cm, weight: 62kg) after single full breath-holding. Three dimensional lung images were reconstructed (minimal threshold value: -1,000HU, maximal threshold values: -150,-250, -350, -450HU) to obtain total lung volume(TLV) on a histogram. Total lung volume measured by spiral CT was compared with TLV obtained by spirometry. RESULTS: Mean TLV measured by spirometry was 5.62 Land TLV measured by CT at maximal threshold values of -150, -250, -350, and -450HU was 6.63, 5.33, 5.15, and 4.98 L, respectively. Mean absolute differences between the modalities of 0.17L(3%), 0.32L(5.6%), 0.48L(8.5%), 0.65L(11.5) were statistically significant(p<0.001). Linear regression coefficients between the modalities were 0.99, 0.97, 0.95,and 0.94 and no statistically significant differences in accuracy of threshold levels in the estimation of lung volume(r=0.99, standard error=0.034L in all) were seen. CONCLUSION: TLV measured by spiral CT closely approximated that measured by spirometry. Spiral CT may be useful as a means of evaluating lung function.
Adult ; Female ; Humans ; Linear Models ; Lung ; Male ; Spirometry* ; Tomography, Spiral Computed* ; Total Lung Capacity*

STUDY DESIGN: Retrospective case series. PURPOSE: The purpose of this study was to examine the incidence of neural axis abnormalities and the relevant risk factors in patients with adolescent idiopathic scoliosis (AIS). OVERVIEW OF LITERATURE: The use of preoperative magnetic resonance imaging (MRI) to assess the whole spine in patients with idiopathic scoliosis is controversial, and indications for such MRI evaluations have not been definitively established. However, we routinely use whole-spine MRI in patients with scoliosis who are scheduled to undergo surgical correction. METHODS: A total of 378 consecutive patients with presumed AIS who were admitted for spinal surgery were examined for neural axis abnormalities using MRI. To differentiate patients with normal and abnormal MRI findings, the following clinical parameters were evaluated: age, sex, menarcheal status, rotation angle (using a scoliometer), coronal balance, shoulder height difference, and low back pain. We radiographically evaluated curve type, thoracic or thoracolumbar curve direction, curve magnitude and flexibility, apical vertebral rotation, curve length, coronal balance, sagittal balance, shoulder height difference, thoracic kyphosis, and the Risser sign. RESULTS: Neural axis abnormalities were detected in 24 patients (6.3%). Abnormal MRI findings were significantly more common in males than in females and were associated with increased thoracic kyphosis. However, there were no significant differences in terms of the other measured parameters. CONCLUSIONS: Among the patients with presumed AIS who received preoperative whole-spine MRI, 6.3% had neural axis abnormalities. Males and patients with increased thoracic kyphosis were at a higher risk.
Adolescent* ; Female ; Humans ; Incidence ; Kyphosis ; Low Back Pain ; Magnetic Resonance Imaging* ; Male ; Pliability ; Retrospective Studies ; Risk Factors ; Scoliosis* ; Shoulder ; Spine

OBJECTIVES: In order to investigate the maturational process of intracellular signal transduction system in rat brain, we studied the induction of the immediate early genes(IEGs)c-fos, junB, and TIS1 in each developmental stage after kainic acid(KA)induced seizure in young rat hippocampus and then compared these with the results after electroconvulsive shock(ECS) And to elucidate the induction mechanism of c-fos via mitogen-activated protein kinase(MAPK)by KA in each developmental stage, we investigated the phosphorylation of p42, p44 MAPK and Elk-1 after KA treatment in young rat hippocampus. METHODS: We examined the induction patterns of IEGs by northern blot analysis, and the phosphorylation of p42, p44 MAPK and Elk-1 by immunoblotting in rat hippocampus at post-natal day 7, 14, and 21(P7, P14 & P21) respectively after intraperitoneal injection of KA. RESULTS: Unlike ECS, KA did not induce c-fos, junB, and TIS1 in P7 hippocampus. But these genes were apparently induced at P14 and to an adult level at P21. These three IEGs showed similar temporal patterns of induction in each developmental stage. Although the basal level of phosphorylated 42p, 44p MAPK was considerable in P7 rat hippocampus, the increase of phosphorylation after KA treatment was observed at P14 . While the phosphorylation of Elk-1 was detected with high basal level in P7 rat, the amount of phosphorylated Elk-1 was not changed after KA treatment. CONCLUSION: Our results suggest that the differences in IEGs induction patterns between KA and ECS may be due to the differences in the activated signal transduction pathways. And our results also implicate that the signal transduction system involved in MAPK phosphorylation after KA treatment mature with aging and c-fos induction via MAPK activation may be regulated through some pathways other than Elk-1 in rat hippocampus.
Adult ; Aging ; Animals ; Blotting, Northern ; Brain ; Genes, Immediate-Early* ; Hippocampus* ; Humans ; Immunoblotting ; Injections, Intraperitoneal ; Kainic Acid* ; Mitogen-Activated Protein Kinase 3* ; Phosphorylation* ; Rats* ; Seizures ; Signal Transduction

Primary amyloidosis has unfavorable prognosis, particularly with organ involvement. Here, we report a case of clinical remission of renal amyloidosis after autologous hematopoietic cell transplantation. A 51-year-old female patient visited our hospital due to generalized edema. Initial evaluation showed hyperlipidemia, hypoalbuminemia, and heavy proteinuria, which were consistent with nephrotic syndrome. However, IgM lamda type monoclonal gammopathy was detected in serum and urine electrophoresis studies. Renal biopsy showed Congo red-positive amyloid deposition in mesangial area, glomerular capillary walls, and arterioles and amyloid fibers were confirmed by electron microscopy. Immunohistochemial study of the biopsy tissue demonstrated systemic light-chain amyloidosis (AL amyloidosis). Multiple myeloma was not evident on bone marrow examination. She received autologous hematopoietic cell transplantation after high dose melphalan treatment. Complete remissions were achieved after the treatment, respectively. Our findings suggest the potential role of autologous peripheral blood stem cell transplantation in treatment of AL amyloidosis.
Amyloid ; Amyloidosis* ; Arterioles ; Biopsy ; Bone Marrow Examination ; Capillaries ; Cell Transplantation ; Congo ; Edema ; Electrophoresis ; Female ; Humans ; Hyperlipidemias ; Hypoalbuminemia ; Immunoglobulin M ; Melphalan ; Microscopy, Electron ; Middle Aged ; Multiple Myeloma ; Nephrotic Syndrome ; Paraproteinemias ; Peripheral Blood Stem Cell Transplantation* ; Plaque, Amyloid ; Prognosis ; Proteinuria ; Transplants

Primary amyloidosis has unfavorable prognosis, particularly with organ involvement. Here, we report a case of clinical remission of renal amyloidosis after autologous hematopoietic cell transplantation. A 51-year-old female patient visited our hospital due to generalized edema. Initial evaluation showed hyperlipidemia, hypoalbuminemia, and heavy proteinuria, which were consistent with nephrotic syndrome. However, IgM lamda type monoclonal gammopathy was detected in serum and urine electrophoresis studies. Renal biopsy showed Congo red-positive amyloid deposition in mesangial area, glomerular capillary walls, and arterioles and amyloid fibers were confirmed by electron microscopy. Immunohistochemial study of the biopsy tissue demonstrated systemic light-chain amyloidosis (AL amyloidosis). Multiple myeloma was not evident on bone marrow examination. She received autologous hematopoietic cell transplantation after high dose melphalan treatment. Complete remissions were achieved after the treatment, respectively. Our findings suggest the potential role of autologous peripheral blood stem cell transplantation in treatment of AL amyloidosis.
Amyloid ; Amyloidosis* ; Arterioles ; Biopsy ; Bone Marrow Examination ; Capillaries ; Cell Transplantation ; Congo ; Edema ; Electrophoresis ; Female ; Humans ; Hyperlipidemias ; Hypoalbuminemia ; Immunoglobulin M ; Melphalan ; Microscopy, Electron ; Middle Aged ; Multiple Myeloma ; Nephrotic Syndrome ; Paraproteinemias ; Peripheral Blood Stem Cell Transplantation* ; Plaque, Amyloid ; Prognosis ; Proteinuria ; Transplants

BACKGROUND: Antepartum, intrapartum, and postpartum preventive measures with antiretroviral drugs, appropriate delivery methods, and discouraging breastfeeding significantly decrease the risk of mother-to-child transmission of human immunodeficiency virus (HIV) infection. Herein, we investigated the pregnancy outcomes in HIV-infected Korean women. METHODS: We retrospectively reviewed medical records of childbearing-age HIV-infected women between January 2005 and June 2017 at four tertiary care hospitals in Korea. RESULTS: Among a total of 95 HIV infected women of child-bearing age with 587.61 years of follow-up duration, 15 HIV-infected women experienced 21 pregnancies and delivered 16 infants. The pregnancy rate was 3.57 per 100 patient-years. Among the 21 pregnancies, five ended with an induced abortion, and 16 with childbirth including two preterm deliveries at 24 and 35 weeks of gestation, respectively. The two preterm infants had low birth weight and one of them died 10 days after delivery due to respiratory failure. Among the 14 full-term infants, one infant was small for gestational age. There were no HIV-infected infants. CONCLUSION: The pregnancy rate of HIV-infected women in Korea is lower than that of the general population. Although several adverse pregnancy outcomes were observed, mother-to-child transmission of HIV infection was successfully prevented with effective preventive measures.
Abortion, Induced ; Breast Feeding ; Female ; Follow-Up Studies ; Gestational Age ; HIV ; HIV Infections ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Korea* ; Medical Records ; Parturition ; Postpartum Period ; Pregnancy Outcome ; Pregnancy Rate* ; Pregnancy* ; Respiratory Insufficiency ; Retrospective Studies ; Tertiary Healthcare

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization