No abstract available.
Head*

BACKGROUND: This study was conducted to compare the clinical and radiological outcomes of the locking hook plate fixation (HP) technique and the single tight rope (TR) technique applied for acute high-grade acromioclavicular (AC) joint separations. METHODS: Between 2009 and 2014, 135 consecutive patients with acute AC joint separation Rockwood types III, IV, and V were subjected to surgical reconstruction. One hundred fourteen patients (84.4%) were available for retrospective evaluation. Of them, 62 and 52 were treated using the single TR group and clavicular HP group techniques, respectively. The visual analogue scale, Constant, American Shoulder and Elbow Surgeons (ASES), and Taft scores were used for clinical assessment. Postoperative shoulder range of motion was also assessed. An anteroposterior radiograph of the coracoclavicular distance (CCD) was obtained to evaluate the radiographic signs of recurrence. RESULTS: The TR group patients had better Constant, ASES, and Taft scores than the HP group patients. The loss of reduction in terms of the CCD did not differ between groups. Subacromial osteolysis was observed in 34.6% of the cases in the HP group. However, there were no significant differences in the clinical outcomes between the patients with and without osteolysis in the HP group. Subcoracoid osteolysis, drill tunnel widening, and metal displacement were observed in 3.2%, 22.6%, and 4.8% of the cases in the TR group, respectively. CONCLUSIONS: The single TR technique was relatively more effective at treating acute high-grade AC joint injuries than the HP fixation technique (level of evidence: therapeutic; retrospective comparative study, Level III).
Acromioclavicular Joint* ; Dislocations* ; Elbow ; Humans ; Joints ; Osteolysis ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Shoulder ; Surgeons

No abstract available.
Humerus*

Multiple dermatofibromas are rare and some case reports show this disease has been related to generalized defective immune function: autoimmune disease and altered immunity, such as AIDS and systemic lupus erythematosus(SLE), can be treated with immunosuppressive agents. But there are no specific reports of this disease developing in healthy people. We describe a case of multiple dermatofibromas in a 38-year-old healthy man who showed no abnormality of the immune function.
Adult* ; Autoimmune Diseases ; Histiocytoma, Benign Fibrous* ; Humans ; Immunosuppressive Agents

There are several rnethods to correct the tibial bony defect including resection, cement filling, autograft or allograft and metal augmentation. The purpose of this study is to find the adequate treatment method of tibia bony defect through analysis of the result with above methods. From Sep. 1993 to Dec. 1997, the authors analyzed 93 cases of tibial medial bony defect corrected by overresection of lateral condyle, allograft and metal wedge or block among 358 cases of primary total knee arthroplasty(TKA) operated at Asan Medical Center. All cases were devided into four groups according to the treatment method; group A(31 cases) with overresection of lateral condyle, group B(37 cases) with metal wedge, group C(21 cases) with metal block and group D(4 cases) with allograft. The mean follow up period was 23.6 months(12 56 months). The results were as follows, 1. There were no definite statistical difference between group A, B, C and D in HSS knee score, ROM, correction of deformity. But in group D, there is one case of loss of the correction. 2. Loosening of the implant was not noted, but 17 cases of mild bony resorption was found just beneath the implant. It was particularly prominent in group B(9 cases) than group A(5 cases) and C(3 cases). 3. Among 4 cases of allograft, one has developed collapse of allograft. 4. 3 cases of deep infection developed only in group C, which were followed by revision TKA. Although further follow up study should be carried out, we concluded that resection of lateral tibial condyle, allograft, metal augmentation is a good substitute to the correction of the tibial bony defect in primary TKA.
Allografts ; Autografts ; Chungcheongnam-do ; Congenital Abnormalities ; Follow-Up Studies ; Knee ; Tibia

We report a case of primary cutaneous mucinous adenocarcinotna in a 64-year-old female. The tumor was about 2cm in size, forminga round dome-shaped alopecic scalp mass which had gradually increased in size over about 5 years, Histalogic examination revealed that the tumor was divided into numerous compartments by strands of fibrous tissue. In each compartment, abundant amounts of pale-staining mucin surrounded nests or cords of moderately anaplastic epithelial cells. We couldn't find any evidence of internal neoplasms as a source of metastasis. We resected the tumor with approximately a 1 cm margin and then performed a split thickness skin graft.
Adenocarcinoma, Mucinous* ; Betazole ; Epithelial Cells ; Female ; Humans ; Middle Aged ; Mucins* ; Neoplasm Metastasis ; Scalp ; Skin ; Transplants

PURPOSE: To analyze contrast-enhancement pattern of stomach cancer on dynamic MRI and to verify the efficacy of intravenous contrast agent in the evaluation of stomach cancer. MATERIALS AND METHODS: Twelve patients with proven stomach cancer underwent dynamic MRI, By using 1.0T scanner, we obtained precontrast FLASH images, and 30, 60, 90 second delay FLASH images after intravenous contrast injection. All patients ingested on liter of water and had intramuscluar injection of Buscopan just before MR study. For quantitative analysis we measured signal to noise ratio (S/N) of stomach cancer on each image, and signal difference to noise ratio (SD/N) between cancer and intraluminal fluid, cancer and the pancreas. For qualitative analysis two radiologists evaluated lesion conspicuity on each image by grading system(grade 0, 1, 2, 3: poor, fair, good, excellent). RESULTS: S/N of stomach cancer increased gradually by time(precontrast, 30, 60, 90 second delay:38.7, 42.5, 57.4, 65.7). SD/N between cancer and intraluminal fluid significantly increased after contrast enhancement(1.24, 25.01, 39.30, 45.89). SD/Ns between cancer and the pancreas were 10.5, 9.33, 9.99, 10.66 respectively. In qualitative analysis, precontrast images were better than postcontrast images for delineation of stomach cancer, Postcontrast images showed clear endo-luminal side of stomach cancer, but outer margin of stomach cancer was more distinct on precontrast images. CONCLUSION: Precontrast MR images are better than postcontrast MR images in the depiction of stomach cancer. Intravenous contrast agent is not imperative in the evaluation of stomach cancer.
Butylscopolammonium Bromide ; Humans ; Magnetic Resonance Imaging* ; Noise ; Pancreas ; Signal-To-Noise Ratio ; Stomach Neoplasms* ; Water

BACKGROUND : Treatment of a severe burn injury with total parenteral nutrition can produce bacterial translocation to mesenteric lymph nodes through the intestinal mucosa due to permeability changes. Early enteral feeding will help to restore the mucosal barrier function. Certain nutrients may have a beneficial effect on bacterial translocation and gut immunity. METHODS : We choose the glutamine and korean cabbage as dietary factors to study the beneficial effect on gut immunity of feeding different dietary formulations of low amino acid concentrated total parenteral nutritional fluids in burned rats. Forty-eight (48) male pathogen-free Sprague-Dowley rats were allocated in 4 groups(group A, control chow diet and water ad libitum; group B, oral TPN diet; group C, oral TPN diet supplemented with 2% glutamine; and group D, oral TPN diet supplemented with korean cabbage). All groups, except control group A, recieved 40% total body surface area, full-thickness burn injury. Group A received sham burn injury. Bacterial translocation to mesenteric lymph nodes, the cecal bacterial population level, the intestinal mucosal protein content, and the total IgA of the intestinal luminal washing fluid were measured and light-microscope changes of the small intestine were observed in the rats on the 4th and the 7th days after corresponding diet intake. RESULTS : The incidence of bacterial translocation in the oral TPN diet group B was reduced signifi cantly compared with control group A and glutamine supplemented group C on 4th day postburn (p< 0.05) The cecal bacterial population level of control group A showed significant lower values, compared with the other groups, in total aerobic (on 4th day p<0.01, on 7th day p<0.01) and gram-negative enterics species (on 4th day p<0.01, on 7th day p<0.05). The mucosal protein amount per cm of length of intestine was decreased slightly in groups B, C, and D, compared with the control group A, but without statistical significance, on the 7th day postburn. The total (serum and secretary) IgA per cm of length of intestine was increased significantly in the glutamine-supplemented group C and the cabbage- sup plemented group D on the 7th day postburn, compared with the oral TPN group B (p<0.05). However,there was no corresponding decrease in the bacterial translocation ratio or the cecal bacterial population level. Histologic observations on the 4th and the 7th days of glutamine-supplemented group C & cabbage- supplemented group D revealed increases in the villous height, and the numbers of villous cells and goblet cells, compared with the oral TPN group B. A slight desquamation of the villous cells was observed in the cabbage-supplemented group on the 7th day. CONCLUSION : In summary, early enteral feeding is not sufficient to avoid bacterial translocation. Certain nutritional factors such as glutamine are helpful in overcoming the bacterial translocation in burned rats. Korean cabbage was beneficial became promoted an IgA increase in the intestine without a direct effect on the bacterial translocation.
Animals ; Bacterial Translocation* ; Body Surface Area ; Brassica ; Burns ; Diet ; Enteral Nutrition ; Food, Formulated ; Glutamine* ; Goblet Cells ; Humans ; Immunoglobulin A ; Incidence ; Intestinal Mucosa ; Intestine, Small ; Intestines ; Lymph Nodes* ; Male ; Parenteral Nutrition, Total ; Permeability ; Phenobarbital ; Rats* ; Water

No abstract available.
Female ; Metrorrhagia*

No abstract available.
Arthritis, Rheumatoid* ; Humans