Bone injuries of the extremities can be found in 0.2-2% of all living newborns. The most common location of the fracture was clavicle, and followed by humerus, femur in orders. Fractures of the femur are relatively rare. Authors have analyzed 9 cases of the femoral shaft fractures in the newborns, treated at Severence Hospital from January 1985 to March 1992. Seven cases were born by Cesarean section, two cases were by normal spontaneous vaginal delivery. Vertex presentation were three cases, breech presentation were five cases, and transverse presentation was one case. The mean birth weight was 2.93kg and four cases were born in prematurity. The location of fracture were seven cases in proximal shaft, one case in mid shaft, and one case in distal shaft. The type of fracture were all spiral fracture except two fractures. Five cases were treated by splint and 4 cases were treated by traction method. No further immobilization was needed for 8 cases but two weeks long leg cast after splint was applied for one case. Two cases of complication were noted. Skin necrosis developed due to the traction to the popliteal fossa and minimal anterior angulation of femora, and no functional deficit were found, but bony protrusion of proximal femora were palpated.
Birth Weight ; Breech Presentation ; Cesarean Section ; Clavicle ; Extremities ; Female ; Femur ; Humans ; Humerus ; Immobilization ; Infant, Newborn ; Leg ; Methods ; Necrosis ; Parturition ; Pregnancy ; Skin ; Splints ; Traction

PURPOSE: To evaluate the long-term anatomical and functional results of macular buckling for retinal detachment associated with a macular hole in high myopia. METHODS: Eleven consecutive highly myopic eyes with retinal detachment and macular holes were retrospectively studied between January 2002 and September 2010. All cases developed after pars plana vitrectomy for internal limiting membrane removal, for the treatment of retinal detachment associated with a macular hole, or vitreomacular traction with a macular hole. Macular buckling with an episcleral sponge was performed for all cases. The mean follow-up period after macular buckling was 45.1 months (range from 12 to 102 months). Retinal reattachment and macular hole closure after the surgery and best-corrected visual acuity before and after the surgery were evaluated. RESULTS: Nine out of 11 eyes were successfully treated with the macular buckling procedure. In the remaining 2 eyes, retinal re-detachment occurred with anterior proliferative vitreoretinopathy. In these eyes, successful retinal attachment occurred after reoperation with silicone oil tamponade. Optical coherence tomography (OCT) was performed after the surgery in 10 out of 11 eyes and the macular hole closure rate was 30%. The mean best corrected visual acuity went from counting fingers preoperatively to 0.06 postoperatively. CONCLUSIONS: The macular buckling procedure is effective for retinal detachment associated with a macular hole in high myopia, especially following an unsuccessful pars plana vitrectomy with removal of inner retinal traction.
Eye ; Fingers ; Follow-Up Studies ; Membranes ; Myopia ; Porifera ; Reoperation ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Silicone Oils ; Tomography, Optical Coherence ; Traction ; Visual Acuity ; Vitrectomy ; Vitreoretinopathy, Proliferative

We aimed to review whether pretreatment inflammatory markers reflect the short- and long-term outcomes of patients with colon cancer, rectal cancer, colon and rectal cancers, and metastatic colorectal cancer (CRC). We found that pretreatment complete blood count and blood chemistry tests reflect short-term and long-term oncological outcomes in patients with CRC. Specifically, in patients with colon cancer, hypoalbuminemia was associated with worse postoperative morbidity, mortality, and inferior survival. In patients with rectal cancer, elevated neutrophil-lymphocyte ratio (NLR) and thrombocytosis were associated with postoperative complications, poor overall survival (OS), and disease-free survival (DFS). A high C-reactive protein/albumin ratio (CAR) was associated with poor OS and DFS. In patients with metastatic CRC, increased NLR and platelet-lymphocyte ratio (PLR) were associated with poor OS, DFS, and progression-free survival (PFS). In addition, high CAR and a low albumin/globulin ratio on blood chemistry tests were associated with poor OS and PFS. Although universal cut-off values were not available, various types of pretreatment laboratory markers could be utilized as adjuncts to predict prognosis in patients with CRC.

As chorion and amnion fusion usually occurs between 14 and 16 weeks of gestation, sonographic identification of chorion and amniotic membrane separation is a normal finding before 14 weeks. However, persistent separation after 16 weeks of gestation is considered rare and abnormal findings. Complete chorioamniotic membrane separation (CMS) may occur spontaneously, but has also been described as a complication of all invasive intrauterine procedures, including amniocentesis. Complete CMS have a significant morbidity and mortality due to intrauterine fetal death, cord complications, and preterm delivery. Aggressive treatment with hospitalization is necessary. We now report 2 cases of complete CMS identified by prenatal ultrasound; 1 in spontaneous complete CMS diagnosed at 24 weeks of gestation, and health premature child was born at 29+3 weeks of gestation, who was alive and well at present; 1 in complete CMS diagnosed at 21 weeks of gestation after amniocentesis, and fetal demise at 24 weeks of gestation due to cord strangulation by an amniotic band. We experienced two cases of complete CMS and report with a brief review of literatures.
Amniocentesis ; Amnion ; Amniotic Band Syndrome ; Child ; Chorion ; Fetal Death ; Hospitalization ; Humans ; Infant, Newborn ; Membranes ; Pregnancy

BACKGROUND AND OBJECTIVES: Excretion of bile acid and free cholesterol of bile was important to maintain cholesterol homeostasis. ATP-binding cassette transporter G5 (ABCG5) and G8 (ABCG8) promoted biliary cholesterol excretion. In previous study, hepatic secretion of cholesterol and ABCG5/G8 expression are strongly stimulated in hypophysectomized rats during treatment with thyroid hormone. In this study, we aimed to evaluate the effect of thyroid hormone to expression of ABCG5 and G8 in mouse liver. MATERIALS AND METHODS: We administered thyroid hormone (T3) to C57BL/6 mice and then RNA and protein was isolated from liver. We isolated primary hepatocyte and administered T3 to evaluate in vitro effect. HepG2 cells were cotransfected with either a control plasmid or expression plasmids for human thyroid hormone receptor (hTR)beta/human retinoid X receptor (hRXR)alpha or human liver X receptor (hLXR)alpha in combination with reporter plasmids TK-LXRE3-LUC with or without T3. RESULTS: Serum total cholesterol was decreased after 5 days of T3 treatment. Expression of ABCG5/8 mRNA and ABCG5 protein was increased after T3 treatment. In primary hepatocytes, T3 also increased ABCG5/8 mRNA expression. LXRalpha mRNA was not increased by T3. However, when we cotransfected liver X receptor response element (LXRE) construct and TRbeta/RXRalpha with T3, the activity of LXRE containing construct was markedly increased. CONCLUSION: We confirmed that thyroid hormone increased expression of ABCG5/8. This result suggested that thyroid hormone played an important role in decreasing serum cholesterol through bile excretion.
Animals ; Bile ; Cholesterol ; Hep G2 Cells ; Hepatocytes ; Homeostasis ; Humans ; Liver ; Mice ; Orphan Nuclear Receptors ; Plasmids ; Rats ; Receptors, Thyroid Hormone ; Response Elements ; Retinoid X Receptors ; RNA ; RNA, Messenger ; Thyroid Gland ; Thyroid Hormones

PURPOSE: Both human NIS and mutant D2R transgenes are proposed as reporting system in transplanted cell tracking. Using hepatoma cell lines, we constructed a dual reporter system containing human sodium-iodide symporter (hNIS) and dopamine 2 receptor (D2R) and compared its characteristics. MATERIALS AND METHODS: The recombinant plasmid (pIRES-hNIS/D2R) was constructed with IRES (internal ribosome entry site) under control of the CMV promoter. pIRES-hNIS/D2R was transfected to human hepatoma SK-Hep1 cell line with lipofectamine. HEP-ND (SK-Hep1-hNIS/D2R) cells stably expressing hNIS and D2R was established by selection with G418 for two weeks. RT-PCR was performed to investigate the expression of both hNIS and D2R genes. The expressions of hNIS and D2R were measured by 125I uptake assays and receptor binding assays. Specific binding of D2R to [3H]spiperone was verified by Scatchard plot with (+) butaclamol as a specific inhibitor. K (d) and B (max) values were estimated. The correlation between hNIS and D2R expression was compared by using each clone. RESULTS: Similar quantities of hNIS and D2R genes were expressed on HEP-ND as RT-PCR assays. HEP-ND cells showed 30 to 40 fold higher radioiodine uptakes than those of parental SK-Hep1 cells. 125I uptake in HEP-ND cells was completely inhibited by KClO4, a NIS inhibitor. Specific binding to HEP-ND cells was saturable and the K (d) and B (max) values for HEP-ND cells were 2.92 nM, 745.25 fmol/mg protein and 2.91nM, 1323 fmole/mg protein in two clones, respectively. The radioiodine uptake by hNIS activity and D2R binding was highly correlated. CONCLUSION: We developed a dual positron and gamma imaging reporter system of hNIS and D2R in a stably transfected cell line. We expect that D2R and hNIS genes can complement mutually as a nuclear reporting system or that D2R can be used as reporter gene when hNIS gene were used as a treatment gene.
Butaclamol ; Carcinoma, Hepatocellular ; Cell Line ; Cell Tracking ; Clone Cells ; Complement System Proteins ; Dopamine* ; Electrons ; Genes, Reporter ; Humans ; Ion Transport* ; Parents ; Plasmids ; Ribosomes ; Sodium Iodide* ; Sodium* ; Transgenes*

The borderline tumor is not benign but has low malignant potential, which accounts for 10-15% of all ovarian tumors. The mucinous borderline tumors make up approximately 40% of all borderline tumors. About 5% of mature cystic teratomas of ovary include some with mucinous cystadenoma. The malignant transformation is occurred in about 1-3% of patients who have a mature cystic teratoma. There has been reported frequently about the malignant transformation of a mature cystic teratoma. After the first description of a patient with mucinous borderline tumor associated with a mature cystic teratoma in 1988, the borderline tumorous change of a mature cystic teratoma has been reported rarely. This report presents a patient with atypical proliferating mucinous tumor arising in a mature cystic teratoma.
Cystadenoma, Mucinous ; Female ; Humans ; Mucins ; Ovary ; Teratoma*

BACKGROUND AND PURPOSE: The elderly population and the prevalence of stroke, dementia, and Parkinson's disease are increasing rapidly in Korea. The aim of this study was to establish the length of stay (LOS) for neurological geriatric diseases, and analyze this parameteraccording to healthcare institutions. METHODS: We used data from the Health Insurance Review and Assessment Service from 2003 to 2007. Nineteen neurological geriatric diseases were classified into four groups: dementia, cerebral hemorrhage, cerebral infarction, and Parkinson's disease. LOS was analyzed according to gender, age, insurance type, disease group, and type of healthcare institution. RESULTS: The LOS for neurological geriatric diseases lengthened from 5,550,193 days (10.8% of the total National Health Insurance admission days) in 2003 to 14,749,671 days (19.7%) in 2007. The mean LOS was 40.8 days in 2003, and lengthened to 71.2 days in 2007. After stratification by disease group, the mean LOS for long-term-care hospitals lengthened by 1.43 times (from 81.7 to 116.6 days) in the cerebral infarction group, 1.35 times (from 85.6 to 115.2 days) in the cerebral hemorrhage group, and 1.28 times (from 82.7 to 105.7 days) in the Parkinson's disease group. CONCLUSIONS: The LOS for neurological geriatric diseases has lengthened markedly, which isdue to an increasesin the number of hospitalized patients and the mean LOS, which have increased most rapidly in long-term-care hospitals. These results may be useful in developing geriatric health policies.
Aged ; Cerebral Hemorrhage ; Cerebral Infarction ; Delivery of Health Care ; Dementia ; Health Policy ; Humans ; Insurance ; Insurance, Health ; Korea ; Length of Stay ; National Health Programs ; Parkinson Disease ; Prevalence ; Stroke

Transcranial electrical stimulation-motor evoked potential (TES-MEP) is a valuable intraoperative monitoring technique during brain tumor surgery. However, TES can stimulate deep subcortical areas located far from the motor cortex. There is a concern about false-negative results from the use of TES-MEP during resection of those tumors adjacent to the primary motor cortex. Our study reports three cases of TES-MEP monitoring with false-negative results due to deep axonal stimulation during brain tumor resection. Although no significant change in TES-MEP was observed during surgery, study subjects experienced muscle weakness after surgery. Deep axonal stimulation of TES could give false-negative results. Therefore, a combined method of TES-MEP and direct cortical stimulation-motor evoked potential (DCS-MEP) or direct subcortical stimulation should be considered to overcome the limitation of TES-MEP.
Axons ; Brain Neoplasms* ; Brain* ; Evoked Potentials* ; Methods ; Monitoring, Intraoperative ; Motor Cortex* ; Muscle Weakness ; Transcranial Direct Current Stimulation

OBJECTIVE: This study evaluated the temporal variables of hyolaryngeal movements during normal swallowing using kinematic analysis of the video fluoroscopic swallowing study (VFSS) to present the normal cut-off values of those variables. METHODS: Seventy-five healthy volunteers (17 men, 58 women) without swallowing dysfunctions were recruited to examine the swallowing of 2-ml diluted barium by a VFSS. Kinematic analysis was conducted by digitization of video files for movements of hyolaryngeal structures, including the vocal cords, hyoid bone, and epiglottis during normal swallowing. The time points and duration of hyolaryngeal movements were measured. The time points were the start point, maximal point, and the end point of the LE (Laryngeal Elevation), HE (Hyoid Excursion), and EF (Epiglottic Folding). The durations of LE, HE, and EF were obtained by subtracting the time of the start point from the time of the maximal point. The onset time of LE was defined as the reference time point (0 sec). The upper and lower limits of the 95% confidence interval were adopted as the normal cut-off values for the temporal variables of hyolaryngeal movements after transformation to a normal distribution. If a transformation formula to a normal distribution was not found in a variable, the values of the 2.5–97.5 percentile were adopted. RESULTS: The cut-off values of the maximal and end points of the LE were 0.281 to 0.916 sec, and 0.830 to 2.205 sec, respectively. The cut-off values of the start, maximal and end points of the HE were −0.233 to 0.400 sec, 0.320 to 0.874 sec, and 0.889 to 2.055 sec, respectively. The cut-off values of the start, maximal, and end points of the EF were 0.017 to 0.483 sec, 0.364 to 1.055 sec, and 0.774 to 1.773 sec, respectively. The cut-off values of the duration of LE, HE, and EF were 0.281 to 0.916 sec, 0.258 to 0.767 sec, and 0.255 to 0.787 sec, respectively. CONCLUSION: This study presented the normal cut-off values of temporal variables of hyolaryngeal movements during normal swallowing. This study can serve as a basis for classifying and analyzing the patterns of patients with dysphagia.
Barium ; Deglutition Disorders ; Deglutition* ; Epiglottis ; Healthy Volunteers ; Humans ; Hyoid Bone ; Male ; Vocal Cords