BACKGROUND: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. METHODS: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. RESULTS: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. CONCLUSIONS: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.
Acromion ; California ; Clavicle* ; Humans ; Osteolysis ; Periprosthetic Fractures ; Shoulder ; Skin

A solitary, asymptomatic lesion, clinically resembling a transpare it cyst, has been present for 4 months in the vaginal mucosa of a 43-year-old healthy woman. An xcisional biopsy revealed the lesion to be a focal accumulatition of hyaluronic acid replacing the collagen fibers and fibroblastic proliferation in the dermis consistant with cutaneous focal mucinosis. During the follow-up period for 3 months, no recurrence was observed.
Adult ; Biopsy ; Collagen ; Dermis ; Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; Mucinoses* ; Mucous Membrane* ; Recurrence

A solitary, asymptomatic lesion, clinically resembling a transpare it cyst, has been present for 4 months in the vaginal mucosa of a 43-year-old healthy woman. An xcisional biopsy revealed the lesion to be a focal accumulatition of hyaluronic acid replacing the collagen fibers and fibroblastic proliferation in the dermis consistant with cutaneous focal mucinosis. During the follow-up period for 3 months, no recurrence was observed.
Adult ; Biopsy ; Collagen ; Dermis ; Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; Mucinoses* ; Mucous Membrane* ; Recurrence

PURPOSE: To evaluate the diagnostic accuracy of chest x-ray interpretation of diffuse calcification of pulmonary nodules. MATERIALS AND METHODS: On plain chest radiograph and CT, 152 pulmonary nodules with diffuse calcification in 98 patients were selected. The nodules were of various diameters : 44 were of 0.5 - 1cm (Group1), 58 were of 1 - 2cm (Group 2), and 50 were of 2 - 3cm (Group 3). On plain chest radiograph, diffuse calcification was considered to be present when the density of pulmonary nodules of 0.5 - 1cm and 1 - 2cm indiameter was greater than that of the overlapping area of the second and fifth ribs. The density of nodules 2-3cmin diameter was compared with that of the mid-claviclar cortex; calcification was considered to be present when the density of the former was greater than that of the latter. Diffuse calcification of a pulmonary nodule on CT image was considered to be present when more than 10% of the area of the nodule showed a higher attenuation than the surrounding rib cortex. RESULTS: The overall diagnostic accuracy of chest radiographs in the detection of diffuse calcification was as follows : sensitivity 77.6%, specifity 89%, PPV (positive predictive value) 82.3%, NPV(negative predictive value) 86.9%. In group 1, sensivity was 96%, specifity 89.5%, PPV 91.6%, and NPV 94.9%. In group 2 nodules, sensitivity was 77.8%, specifity 91%, PPV 89%, and NPV 81.4%. In group 3, sensitivity was 56%,specifity 88% PPV 56% and NPV 83.9%. CONCLUSION: Chest radiographs showed relatively high accuracy in the diagnosis of diffuse calcificatio of pulmonary nodules, particulary when the nodule was less than 2cm in diameter. As the nodule increased in diameter, diagnostic accuracy declined.
Humans ; Radiography, Thoracic ; Ribs ; Thorax*

No abstract available.
Cause of Death* ; Fever* ; Humans

Purpose: To evaluate the correlation between the fibrillar pattern of the Achilles tendon on ultrasonography (US) and functional outcomes in patients who underwent open tendon repair after Achilles tendon rupture. Materials and Methods: Data of 44 patients who had been subjected to US at least 6 months after repair, during the period between July 2012 and July 2019 were reviewed. Those with bilateral tendon rupture, re-rupture, open injury, and chronic or insertional rupture, were excluded from the review. We divided them into two groups, the homogenous group (HoP) and the heterogenous group (HeP) based on the fibrillar pattern on US. We also divided the HoP into linear and wavy subgroups, and the HeP into no hypoechoic lesion and hypoechoic lesion subgroups. The rupture type of the Achilles tendon, radiographic factors including US and magnetic resonance images, patient-related, surgical factors, and clinical results at the last visit after repair were assessed retrospectively. Results: The tendon thickness was 11.4±1.7 mm in the HoP, and 14.5±3.0 mm in the HeP (p<0.001). A shredded pattern was observed in 17 cases (65.4%) in the HoP, and in 17 cases (94.4%) in the HeP (p=0.031). The mean value of the number of sutures used was 8.9±3.05 in the HoP and 11.39±1.75 in the HeP (p=0.001). The mean value of the difference in calf circumference was 0.9±0.67 cm in the HoP and 1.36±0.71 cm in the HeP (p=0.037). There were no statistically significant differences in the fibrillar patterns and patient-related factors. Conclusion The fibrillar pattern observed after repair was correlated with the functional outcome and showed a significant relationship with the rupture pattern and the number of sutures used. Therefore, we suggest a careful individualized postoperative rehabilitation protocol to maximize functional outcomes by referring to the fibrillar pattern in US, especially in shredded ruptures.

PURPOSE: It is very important to obtain vascular access that resists repeated punctures and maintains an adequate blood flow for performing hemodialysis in patients with end stage renal disease. This study was designed to identify the risk factors that may influence the early patency rate of arteriovenous fistulas (AVFs). METHOD: We analyzed 304 cases of AVFs in 299 patients who underwent hemodialysis access surgery in our hospital from January 2000 to March 2007. The rate of early access failure and the risk factors of early access patency were evaluated retrospectively. RESULT: The rate of early access failure of an AVF was 14.5%. The early access failure group showed a higher incidence in women and in the patients with a previous history of ipsilateral central venous catheterization. Further examination by multivariate analysis demonstrated that a history of ipsilateral central venous catheterization was an independent risk factor for early access failure of AVFs. CONCLUSION: A history of ipsilateral central venous catheterization was an independent risk factor for early access failure of AVFs in this study.
Arteriovenous Fistula ; Catheterization, Central Venous ; Central Venous Catheters ; Female ; Humans ; Incidence ; Kidney Failure, Chronic ; Multivariate Analysis ; Punctures ; Renal Dialysis ; Retrospective Studies ; Risk Factors

PURPOSE: To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain. MATERIALS AND METHODS: This study reviewed the medical records of 157 acute ankle sprain patients who were treated between 2009 and 2014. A total of 101 cases were included in this study except for cases with a combined injury, and could not be followed up for eight weeks after the first visit. The patients were divided according to the treatment modality: a cast immobilization group (64 cases) and functional treatment group (37 cases). The clinical outcomes were assessed retrospectively based on the medical records of each group. The residual symptoms, such as pain, swelling, and instability, at three weeks after the primary treatment and at the last visit were compared. RESULTS: The residual pain and instability were significantly common in the functional treatment group at three weeks. Five cases (7.8%) of pain and one case (1.6%) of instability were in the cast group whereas nine cases (24.3%) of pain and six cases (16.2%) of instability in functional treatment group (p=0.021, p=0.014). On the other hand, there was no meaningful difference at the last follow-up. Residual pain, swelling, and instability at the last visit were noted in three (4.7%), six (9.4%), and four cases (6.3%) in the cast group, and three (8.1%), three (8.1%), and three (8.1%) were observed in the functional treatment group. Six patients refused cast immobilization. CONCLUSION: Although there was no significant difference at the last follow-up, cast immobilization appears to be more effective than a functional brace in terms of early pain relief and early restoration of ankle stability as a treatment for acute ankle lateral sprain in this study.
Ankle Injuries ; Ankle ; Braces ; Follow-Up Studies ; Hand ; Humans ; Immobilization ; Medical Records ; Retrospective Studies ; Sprains and Strains

Histone deacetylase (HDAC) inhibitors represent a novel class of anticancer agents, which can be used to inhibit cell proliferation and induce apoptosis in several types of cancer cells. In this study, we investigated the anticancer activity of MHY4381, a newly synthesized HDAC inhibitor, against human prostate cancer cell lines and compared its efficacy with that of suberoylanilide hydroxamic acid (SAHA), a well-known HDAC inhibitor. We assessed cell viability, apoptosis, cell cycle regulation, and other biological effects in the prostate cancer cells. We also evaluated a possible mechanism of MHY4381 on the apoptotic cell death pathway. The IC50 value of MHY4381 was lower in DU145 cells (IC50=0.31 μM) than in LNCaP (IC50=0.85 μM) and PC-3 cells (IC50=5.23 μM). In addition, the IC50 values of MHY4381 measured in this assay were significantly lower than those of SAHA against prostate cancer cell lines. MHY4381 increased the levels of acetylated histones H3 and H4 and reduced the expression of HDAC proteins in the prostate cancer cell lines. MHY4381 increased G2/M phase arrest in DU145 cells, and G1 arrest in LNCaP cells. It also activated reactive oxygen species (ROS) generation, which induced apoptosis in the DU145 and LNCaP cells by increasing the ratio of Bax/Bcl-2 and releasing cytochrome c into the cytoplasm. Our results indicated that MHY4381 preferentially results in antitumor effects in DU145 and LNCaP cells via mitochondria-mediated apoptosis and ROS-facilitated cell death pathway, and therefore can be used as a promising prostate cancer therapeutic.

PURPOSE: This study was designed to investigate the usefulness of extensile lateral approach for accurate reduction and rigid internal fixation in comminuted intraarticular fractures of calcaneus. MATERIALS AND METHODS:From October 2002 to May 2007, we managed 55 patients (62 cases) with open reduction and internal fixation using extensile lateral approach. Among these, 38 patients (43 cases) who underwent preoperative and postoperative CT scan were enrolled. All patients were evaluated over 24 months after surgery. Bohler angle and Gissane angle on plain X-ray, displacement and step-off of articular surface of calcaneus on CT scan were measured and we compared the difference between preoperative and postoperative value of them. Clinical results were assessed by using AOFAS Ankle-Hindfoot Scale. RESULTS:The average Bohler angle was restored from 6.8 degrees to 23.5 degrees and Gissane angle was improved from 116.4 degrees to 113.5 degrees after operation. The average distance of displacement was restored from 4.2 mm to 1.4 mm and step-off of articular surface was recovered from 5.1 mm to 1.3 mm. Clinical results were excellent in 17 cases, good in 18 cases, fair in 3 cases, and poor in 5 cases. 10 cases developed postoperative complications such as skin necrosis, heel pain, limitation of motion of ankle and subtalar arthritis. CONCLUSION: The extensile lateral approach is valuable for the comminuted intraarticular fractures of calcaneus that enables accurate anatomical reduction and rigid internal fixation by providing direct exposure of subtalar joint.
Animals ; Ankle ; Arthritis ; Calcaneus ; Displacement (Psychology) ; Heel ; Humans ; Intra-Articular Fractures ; Necrosis ; Postoperative Complications ; Skin ; Subtalar Joint