PURPOSE: The purpose of this study was to assess the treatment outcomes and prognosis of Lisfranc joint fracture and dislocation according to the mechanism of injury and treatment method. MATERIALS AND METHODS: Twenty six patients with Lisfranc fracture-dislocation who had been treated surgically were included in this retrospective study. The patients were divided into two groups according to mechanism of injury: direct crushing injury (16 patients) and indirect rotational or compressive injury (10 patients). The patients were also divided into three groups according to the surgical methods. The parameters used were radiographic evaluation, patients' subjective satisfaction levels, length of hospital stay, and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score. Statistical analysis was performed. RESULTS: The mean postoperative AOFAS midfoot score was 78.7. The mean length of stay was 39.6 days. Statistically significant differences in subjective satisfaction, AOFAS midfoot score, and length of hospital stay were observed between the two groups (p<0.05). However, no significance differences were observed between the three groups who were divided according to the different surgical methods (p>0.05). CONCLUSION: Mechanism of trauma and the severity of soft-tissue injury were significant prognostic factors affecting the surgical outcomes of Lisfranc joint fracture and dislocation.
Ankle ; Dislocations* ; Foot ; Humans ; Joints* ; Length of Stay ; Prognosis* ; Retrospective Studies

Dermatoglyphics (fingerprints, palmprints, and palm creases) are helpful in early diagnosis of numeral aberrations of chromosome, each of which has specific dermatoglyphic characteristics. In this study, for early diagnosis of numeral aberrations of chromosome in the Korean population, the dermatoglyphic characteristics of the Korean patients who had various numeral aberrations of chromosome were compared with those of the normal Korean people. The hands of 28 Korean patients, who were previously diagnosed to have numeral aberrations of chromosome (24 Down, 1 Turner, 2 Klinefelter, and 1 cri du chat syndromes) by karyotyping, were imprinted to the paper using watersoluble ink; their dermatoglyphic characteristics were analyzed, and compared with those of 3,216 normal Korean people. In fingerprints of the patients with Down syndrome, ulnar loop pattern was frequent whereas whorl pattern was infrequent, which was more prominent in Mongolian than in Caucasian. In palmprints of the patients with Down syndrome, distances not only between a and b but also between b and c were short; and D was frequently found to traverse the palm. In palm creases of the patients with Down syndrome, palm creases were frequently found to join together; and the total degree of transversality of the normal and simian creases was high whereas that of the Sydney crease was low. In fingerprints of the patients with Turner (XO) and Kinefelter (XXY) syndromes, the X chromosome count was inversely proportional to the total ridge count. These results showed that there is a close relationship between dermatoglyphics and numeral aberrations of chromosome in the Korean population. In order to use dermatoglyphics as a more helpful diagnostic tool, dermatoglyphics of the more patients with numeral aberrations of chromosome should be analyzed using various methods.
Dermatoglyphics* ; Down Syndrome ; Early Diagnosis ; Hand ; Humans ; Ink ; Karyotyping ; X Chromosome

BACKGROUND: The prognostic utility of cardiac biomarkers, high-sensitivity cardiac troponin I (hs-cTnI) and soluble suppression of tumorigenicity-2 (sST2), in non-cardiac surgery is not well-defined. We evaluated hs-cTnI and sST2 as predictors of 30-day major adverse cardiac events (MACE) in patients admitted to the surgical intensive care unit (SICU) following major non-cardiac surgery. METHODS: hs-cTnI and sST2 concentrations were measured in 175 SICU patients immediately following surgery and for three days postoperatively. The results were analyzed in relation to 30-day MACE and were compared with the revised Goldman cardiac risk index (RCRI) score. RESULTS: Overall, 30-day MACE was observed in 16 (9.1%) patients. hs-cTnI and sST2 concentrations differed significantly between the two groups with and without 30-day MACE (P < 0.05). The maximum concentration of sST2 was an independent predictor of 30-day MACE (odds ratio=1.016, P=0.008). The optimal cut-off values of hs-cTnI and sST2 for predicting 30-day MACE were 53.0 ng/L and 182.5 ng/mL, respectively. A combination of hs-cTnI and sST2 predicted 30-day MACE better than the RCRI score. Moreover, 30-day MACE was observed more frequently with increasing numbers of above-optimal cut-off hs-cTnI and sST2 values (P < 0.0001). Reclassification analyses indicated that the addition of biomarkers to RCRI scores improved the prediction of 30-day MACE. CONCLUSIONS: This study demonstrates the utility of hs-cTnI and sST2 in predicting 30-day MACE following non-cardiac surgery. Cardiac biomarkers would provide enhanced risk stratification in addition to clinical RCRI scores for patients undergoing major non-cardiac surgery.
Biomarkers ; Critical Care* ; Humans ; Prognosis ; Troponin I* ; Troponin*

This study aimed to clarify the anatomy of middle rectal artery and pelvic vasculature patterns, and to provide schematic information in a manner applicable to the total mesorectal excision. Forty sides of pelvis from 20 formalinembalmed cadavers (10 male, 10 female) were dissected, and all the pelvic vasculatures from the internal iliac artery were investigated, focusing on the middle rectal artery. Middle rectal arteries were classified into major types depending on their vascular origins. Each type was subdivided into minor types according to variability of the pelvic vasculature. A middle rectal artery was identified in 18 out of 20 cadavers, and in 25 out of 40 pelvic sides. In most cases, the middle rectal artery originated from the internal pudendal artery or inferior gluteal artery. These two arteries arose directly from the anterior trunk of the internal iliac artery or were bifurcated from the gluteal-pudendal trunk. In rare cases, these arteries arose from the posterior trunk of the internal iliac artery. The other origins of the middle rectal artery included the gluteal pudendal trunk, inferior vesical artery, internal iliac artery, obturator artery, and the prostatic artery, and the pelvic vasculatures in these cases also presented variability. The detailed anatomical findings related to the middle rectal artery and pelvic vasculatures are noteworthy for their improved clinical applicability.

Stem cell-based products (SCPs) are an emerging field of veterinary medicine that focuses on the regeneration, repair, or replacement of damaged tissues or organs. However, there are some issues in applying the traditional regulatory guideline for the approval of SCPs as veterinary medicinal products. This article describes the positions of Korea, US, and EU regarding SCPs, and compares the regulatory guidelines of each country for their safety evaluation. Although there are some differences in the regulatory guidelines, similar considerations in identifying the quality of SCPs and their safety has adopted. Overall, these guidelines need to be harmonized among countries.

Purpose: : Intensive care unit (ICU) diaries have been implemented across the international ICU community. This study aimed to comprehend the meaning and nature of the lived experience of patients’ families using the ICU diary in Korea. Methods: : This qualitative study adopted van Manen’s hermeneutic phenomenology. The participants comprised eight women and two men who were the family members of patients in the ICU for more than three days. Data were collected using in-depth interviews and observation from July 2018 to January 2019. Results: : Patients’ families who experienced the ICU diary recognized it with six beings according to time: a good idea, forgotten stuff, burdensome work, touching service, my stuff, and a thing in the memory. The ICU diary had three essential meanings for the families: communication, solace and hope, and a record of life. These findings were rearranged according to van Manen’s fundamental existential, and the lived things and lived others were remarkably confirmed. Conclusion : Patients’ families experienced various ICU diary forms over time and recognized an ICU diary as a means of communication. Therefore, the ICU diary is expected to be used as an intervention between families and healthcare providers in the ICU to support mutual communication.

No abstract available.
Genes, ras* ; Humans

PURPOSE: The purpose of this study was to compare the clinical results between the subacromial injection of the ketorolac and that of the corticosteroid in patients with subacromial shoulder impingement syndrome. MATERIALS AND METHODS: Twenty patients with shoulder impingement syndrome received an injection of 60 mg ketorolac and were evaluated in terms of visual analogue scale (VAS), range of motion (ROM) and Constant-Murley score. The outcomes are compared with the data of patients treated by 40 mg triamcinolone injection, retrospectively. RESULTS: There was no significant difference in the demographics, VAS, ROM, and Constan-Murley score between the two groups before the injection. At the 4 weeks follow-up, pain improvement was significantly greater in the corticosteroid group (2.7±1.53) than in the ketorolac group (4.9±2.08; p=0.001). However 12 weeks after the injection, there was no significant difference in pain improvement between the two groups (ketorolac: 2.9±2.32, corticosteroid: 2.6±1.82; p=0.707). The Constant-Murley score at the final follow-up improved from 33.5 to 52.1 in the corticosteroid group, and from 39.0 to 56.6 in the ketorolac group (p=0.677). ROM was increased in both groups, and external rotation was significantly greater in the ketorolac group than in the corticosteroid group at the final follow-up (ketorolac: 29.3°±9.90°, corticosteroid: 20.8°±7.99°; p=0.005). CONCLUSION: In this study, ketolorac provided an effect equivalent to triamcinolone in the treatment of subacromial shoulder impingement syndrome at 12 weeks after the injection. This result could offer better opportunities to manage patients with diabetes or local and systemic side effects of repetitive use of corticosteroids.
Adrenal Cortex Hormones ; Anti-Inflammatory Agents, Non-Steroidal ; Demography ; Follow-Up Studies ; Glucocorticoids ; Humans ; Ketorolac* ; Range of Motion, Articular ; Retrospective Studies ; Shoulder Impingement Syndrome* ; Shoulder* ; Triamcinolone

The purpose of this study was to evaluate the clinical feasibility, benefits, and limitations of CT fluoroscopy (CTF) -guided percutaneous vertebroplasty (PVP). PVP under the guidance of CTF without additional guidance by conventional C-arm fluoroscopy was performed in a total of 29 vertebral bodies in 21 patients with vertebral compression fractures. While monitoring sectional CTF images, the needle was advanced from the skin to the target vertebra. Contrast media and polymethylmethacrylate (PMMA) were injected into the target vertebra with careful monitoring of their distribution. After the procedure, an evaluation was conducted to determine whether extraosseous leakage of PMMA occurred and whether sufficient filling of PMMA had been achieved. Needle placement into the target vertebra was easily achieved with both the transpedicular and posterolateral approaches. Injection of PMMA and venous leakage of contrast media were carefully monitored in all patients, and early detection of PMMA leaking was achieved in 5 patients. Extraosseous leakage that had not been detected during the procedure was not found upon postoperative evaluation. Pain scales were significantly decreased after the procedure, and no obvious complications occurred following the procedure CTF-guided PVP without the combined use of C- arm fluoroscopy was feasible and showed definite benefits. We believe that, in spite of some limitations, CTF-guided PVP provides an alternative technique appropriate in certain situations.
Tomography, X-Ray Computed ; Spine/radiography/*surgery ; Spinal Fractures/*surgery ; Radiation Dosage ; Polymethyl Methacrylate ; Osteoporosis/*complications ; Orthopedic Procedures/*methods ; Middle Aged ; Male ; Humans ; Fluoroscopy ; Female ; Aged, 80 and over ; Aged

It has been reported that inflammatory diseases such as pneumonitis, retinitis, and hepatitis are associated with human cytomegalovirus (HCMV). Intercellular adhesion molecule (ICAM)-1 is an important inflammatory mediator, helping monocytes adhere to endothelial cells when tissues are infected by pathogen including the HCMV. However, little is known about the mechanism of ICAM-1 stimulation by the HCMV infection in monocytes. In this study, a monocytic cell line THP-1 was used to understand ICAM-1 expression by the HCMV infection. Flow cytometric analyses demonstrated that ICAM-1 was stimulated by the HCMV in THP-1 cells with maximum at 24 hours post infection. The stimulated ICAM-1 expression was dependent on the amount of input virus. In order to understand the mechanism of ICAM-1 stimulation during the HCMV infection, cells were treated with specific inhibitors of key elements in inflammation: NF-kappaB inhibitor PDTC, cyclooxygenase 2 inhibitor NS398, and MEK inhibitor PD98059. Flow cytometric analyses revealed that ICAM-1 expression was decreased when treated with PDTC, but not with NS398 or PD98059. Thus, it is suggested that HCMV-induced ICAM-1 expression in THP-1 cells is associates with NF-kappaB.
Cell Line ; Cyclooxygenase 2 ; Cytomegalovirus ; Endothelial Cells ; Flavonoids ; Hepatitis ; Humans ; Inflammation ; Intercellular Adhesion Molecule-1 ; Monocytes ; NF-kappa B ; Nitrobenzenes ; Pneumonia ; Proline ; Retinitis ; Sulfonamides ; Thiocarbamates ; Viruses