Sternal fracture is relatively common in chest trauma. Mediastinal hematoma secondary to sternal fracture is not in common, and it has minor symptoms such as mild dyspnea and chest tightness, which usually resolve spontaneously. We experienced two cases of extrapericardial tamponade by hematoma caused by sternal fractures. Two patients were diagnosed by chest CT scan and sent to the operating room within 2 hours after arriving at emergency room because of unstable vital signs. Cardiovascular signs were relieved immediatly after the operation. We report these cases with a brief review of the literature.
Cardiac Tamponade ; Dyspnea ; Emergency Service, Hospital ; Hematoma ; Humans ; Operating Rooms ; Sternum ; Thorax ; Tomography, X-Ray Computed ; Vital Signs

Angiolipoma is a rare benign soft tissue tumor, an unusual variant of lipoma,consisting of fatty and vascular components and located in the subcutis, usually in the trunk and extremities. We report a case of posterior mediastinal angiolipo-ma extending into the spinal canal and showing both fat and angiomatous fea-tures on CT scan.
Aged ; Angiolipoma/pathology/*radiography ; Case Report ; Female ; Human ; Mediastinal Neoplasms/pathology/*radiography ; Spinal Canal/*pathology ; Tomography, X-Ray Computed

PURPOSE: The purpose of our study was to describe the clinical and radiological mani-festations of tuberculosis in patients with end-stage renal disease. MATERIALS AND METHODS: The medical records, chest radiographs, and CT scans of 42 patients with tuberculosis among 871 consecutive patients with end-stage renal disease were reviewed. Patterns of initial chest radiographs were categorized as primary, postprimary, miliary, or atypical, according to the predominant radiologic findings. RESULTS: Chest radiographs and CT scans revealed pulmonary tuberculosis in 28 patients and extrapulmonary tuberculosis in 15. The pattern of chest radiographs indicative of pulmonary tuberculosis was primary in 12 cases, postprimary in 11, miliary in one, demonstrated atypical infiltrates in three, and was normal in one. Tuberculosis involved the extrathoracic lymph nodes in six cases, the peritoneum in four, the spine in three, and the bone marrow in two. The primary pattern, seen in 12 patients, manifested as pleural effusion or segmental consolidation, and in ten of the twelve the former was dominant. CONCLUSION: The radiological pattern of pulmonary tuberculosis in end-stage renal disease is often primary, and extrapulmonary involvement is frequent.
Bone Marrow ; Humans ; Kidney Failure, Chronic* ; Lymph Nodes ; Medical Records ; Peritoneum ; Pleural Effusion ; Radiography, Thoracic ; Spine ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Pulmonary

A balanced insertion of a parent may produce normal or carrier offsprings, spontaneous abortions, and chromosomally unbalanced offsprings. This is a rare report of duplication of chromosome 10q22->q24 which has arisen through the segregation of a balanced direct insertion. The partial trisomy 10q is a specific syndrome of mental retardation and malformation characterized by psychomotor delay, growth restriction, distinctive dysmorphic appearances, and, in some cases, cardiac, renal, and ocular abnormalities. We have experienced a case of partial trisomy 10q from maternal balanced insertion, which was prenatally showed severe fetal growth restriction and oligohydramnios, and present it with a brief review of literatures.
Abortion, Spontaneous ; Female ; Fetal Development ; Humans ; Intellectual Disability ; Oligohydramnios ; Parents ; Pregnancy ; Trisomy*

OBJECTIVES: This study aimed to observe the decrease in tooth color after home and office bleaching due to consumption of juice, soda, and coffee over a period of one year. METHODS: We obtained written consent from 30 subjects, who were divided into two groups i.e., home bleaching and office bleaching groups. They were treated with opalessence® and Zoom2 whitening gel, and the color of their teeth was assessed using shade Eye-NCC over a one-year period. A self-describing questionnaire was used to determine the frequency of juice, soda, and coffee consumption. RESULTS: The changes in color were measured before and after 1 day, 1 month, 3 months, 6 months, and 12 months. Although the tooth color slightly changed after 12 months, the teeth were brighter than the original color. Consumption of juices, sodas, and coffee is thought to be associated with decrease in tooth color, although the change was not statistically significant. CONCLUSIONS: The ΔE* values showed that the tooth bleaching effect remained for 12 months. Consuming a normal amount of juice, sodas, and coffee does not significantly reduce tooth color after tooth bleaching.
Coffee ; Follow-Up Studies* ; Tooth Bleaching* ; Tooth*

Actinomycosis is a chronic suppurative and granulomatous disease caused by gram-positive bacteria, the Actinomyces, which normally resides in the mouth cavity and large bowel. Actinomyces and other bacterial species are concomitantly, on occasion, found, having been designated "companion microbes". Designing a therapeutic regimen that includes coverage for "companion microbes" during the initial treatment course is reasonable. Primary hepatic actinomycosis, which was not found in possible source or associated disease and was coinfected with alpha-strepotcoccus, has not yet been reported in Korea. We report a case of primary hepatic actinomycosis coinfected with alpha-streptococcus presenting fever, chill, right upper quadrant abdominal pain as chief complaints in a 63-year-old woman. Primary hepatic actinomycosis was confirmed by identification of the sulfur granule, which was obtained by ultrasonography-guided percutaneous needle aspiration and biopsy.
Abdominal Pain ; Actinomyces ; Actinomycosis* ; Biopsy ; Female ; Fever ; Gram-Positive Bacteria ; Humans ; Korea ; Middle Aged ; Mouth ; Needles ; Sulfur

PURPOSE: To determine the usefulness of ultrasonic lithotripsy for the fragmentation of large impacted intrahepatic duct(IHD) stones. MATERIALS AND METHODS: Large impacted stones in five patients were fragmented with a 12.5F rigid ureterorenoscope and a 5.5F rigid ultrasonic oscillating burr via T-tube tract. Two to three dayslater, the fragmented stones were extracted via T-tube tract with basket. RESULTS: Disintegration was complete in three patients and partial in two. The fragmented stones were completely removed in four patients and partially in one. due to that patient's refusal. CONCLUSION: Insertion of a rigid endoscope and ultrasound drill into theorifice of the IHD can be performed without problem. Ultrasonic lithotripsy is an effective technique for the fragmentation of large impacted intrahepatic stones located in the or ifice of the IHD.
Bile Ducts, Intrahepatic* ; Disulfiram ; Endoscopes ; Humans ; Lithotripsy* ; Ultrasonics* ; Ultrasonography

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease caused by the degeneration of motor neurons. Mutations in Cu/Zn superoxide dismutase (SOD1), including G93A, were reportedly linked to familial ALS. SOD1 is a key antioxidant enzyme, and is also one of the major targets for oxidative damage in the brains of patients suffering from Alzheimer's disease (AD). Several lines of evidence suggest that intracellular amyloid beta (Abeta) is associated with the pathogenesis of AD. In this report we demonstrate that intracellular Abeta directly interacts with SOD1, and that this interaction decreases the enzymatic activity of the enzyme. We observed Abeta-SOD1 aggregates in the perinuclear region of H4 cells, and mapped the SOD1 binding region to Abeta amino acids 26-42. Interestingly, intracellular Abeta binds to the SOD1 G93A mutant with greater affinity than to wild-type SOD1. This resulted in considerably less mutant enzymatic activity. Our study implicates a potential role for Abeta in the development of ALS by interacting with the SOD1 G93A mutant.
Amino Acid Sequence ; Amyloid beta-Protein/chemistry/*metabolism ; Amyotrophic Lateral Sclerosis/*enzymology ; Apoptosis ; Cell Line ; Cell Line, Tumor ; Humans ; Molecular Sequence Data ; Point Mutation ; Protein Binding ; Protein Interaction Domains and Motifs ; Superoxide Dismutase/genetics/*metabolism

OBJECTIVES: Vacuum-assisted breast biopsy (VABB) is a widely used technique for the diagnosis of breast lesions. It is carried out with local anesthesia, but procedural pain and stress are still problematic. Dexmedetomidine is a α-2 receptor agonist that can sedate without significant respiratory depression. The study aimed to report the effectiveness of sedation with monitored anesthesia care (MAC) using dexmedetomidine in VABB. METHODS: This was a retrospective chart review of patients who received VABB under MAC with dexmedetomidine. Forty-seven patients during the period of February 2015 to July 2016 were included. We collected data on patient characteristics, infusion drug and dose, induction to incision time, anesthetic, operation, and recovery time and other complications and vital signs. RESULTS: The mean operating time was 50.1 ± 24.9 minutes, and the anesthetic time was 71.2 ± 28.3 minutes. The mean time from induction to incision was 17.0 ± 5.2 minutes, and the recovery time was 20.1 ± 10.3 minutes. None of the patients needed an advanced airway management. Further, none of them showed hemodynamic instability. CONCLUSIONS: VABB was successfully performed with MAC using dexmedetomidine, and there was no respiratory depression or hemodynamic instability.
Airway Management ; Anesthesia ; Anesthesia, Local ; Biopsy ; Breast ; Dexmedetomidine ; Diagnosis ; Hemodynamics ; Humans ; Respiratory Insufficiency ; Retrospective Studies ; Vital Signs

BACKGROUND: Anti-atherosclerotic effect of dipeptidyl peptidase-4 (DPP-4) inhibitors has been suggested from previous studies, and yet, its association with cardiovascular outcome has not been demonstrated. We aimed to evaluate the effect of DPP-4 inhibitors in reducing mortality and coronary revascularization, in association with baseline coronary computed tomography (CT). METHODS: The current study was performed as a multi-center, retrospective observational cohort study. All subjects with diabetes mellitus who had diagnostic CT during 2007-2011 were included, and 1866 DPP-4 inhibitor users and 5179 non-users were compared for outcome. The primary outcome was all-cause mortality and secondary outcome included any coronary revascularization therapy after 90 days of CT in addition to all-cause mortality. RESULTS: DPP-4 inhibitors users had significantly less adverse events [0.8% vs. 4.4% in users vs. non-users, adjusted hazard ratios (HR) 0.220, 95% confidence interval (CI) 0.102-0.474, p = 0.0001 for primary outcome, 4.1% vs. 7.6% in users vs. non-users, HR 0.517, 95% CI 0.363-0.735, p = 0.0002 for secondary outcome, adjusted variables were age, sex, presence of hypertension, high sensitivity C-reactive protein, glycated hemoglobin, statin use, coronary artery calcium score and degree of stenosis]. Interestingly, DPP-4 inhibitor seemed to be beneficial only in subjects without significant stenosis (adjusted HR 0.148, p = 0.0013 and adjusted HR 0.525, p = 0.0081 for primary and secondary outcome). CONCLUSION: DPP-4 inhibitor is associated with reduced all-cause mortality and coronary revascularization in diabetic patients. Such beneficial effect was significant only in those without significant coronary stenosis, which implies that DPP-4 inhibitor may have beneficial effect in earlier stage of atherosclerosis.
Atherosclerosis ; C-Reactive Protein ; Calcium ; Cohort Studies ; Constriction, Pathologic ; Coronary Stenosis ; Coronary Vessels ; Diabetes Mellitus ; Hemoglobin A, Glycosylated ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypertension ; Mortality* ; Retrospective Studies