BACKGROUND: Kirschner's wire (K-wire) transfixation and locking hook plate fixation techniques are widely used in the treatment of acute acromioclavicular joint (ACJ) dislocation. The purpose of this study was to compare the clinical and radiologic outcomes between K-wires transfixation and a locking hook plate fixation technique. METHODS: Seventy-seven patients with acute ACJ dislocation managed with K-wire (56 shoulders) and locking hook plate (21 shoulders) were enrolled for this study. The mean follow-up period was 61 months. RESULTS: At the last follow-up, the shoulder rating scale of the University of California at Los Angeles (UCLA) was higher in patients treated with locking hook plate than with K-wires (33.2 +/- 2.7 vs. 31.3 +/- 3.4, p=0.009). In radiologic assessments, coracoclavicular distance (CCD) (7.9 mm vs. 7.7 mm, p=0.269) and acromioclavicular distance (ACD) (3.0 mm vs. 1.9 mm, p=0.082) were not statistically different from contralateral unaffected shoulder in locking hook plate fixation group, but acromioclavicular interval (ACI) was significant difference. However, there were significant differences in ACI, CCD, and ACD in K-wire fixation group (p<0.001). Eleven complications (20%) occurred in K-wire transfixation group and 2 subacromial erosions on computed tomography scan occurred in locking hook plate fixation group. CONCLUSIONS: ACJ stabilization was achieved in acute ACJ dislocations treated with K-wires or locking hook plates. Locking hook plate can provide higher UCLA shoulder score than K-wire and maintain CCD, and ACD without ligament reconstruction. K-wire transfixation technique resulted in a higher complication rate than locking hook plate.
Acromioclavicular Joint* ; Bone Wires ; California ; Dislocations* ; Follow-Up Studies ; Humans ; Ligaments ; Shoulder

This is a clinical study of 30 cases of congenital malformation of ileum at Severance hospital from 1966 to 1975. They were confirmed after operation and the results were summarized as follows; 1. Total number of patients was 30 cases including 25 males 5 females. Among them 20 cases were included at pediatric agr from birth to 15 years of age. The most frequent occurrence was within 1 month of age with 11 cases. 2. Confirmed diagnesis after operation were 3 cases of ileal duplication,3 cases of ileal stenosis, 2 cases of ileal atresia, 1 cases of ileal hypoplasia, and 21 cases of Meckel's diverticulum. 3. Except for Meckel's diverticuium all the patients were studied which simple abdominal X-ray, which revealed complete and partial intestinal obstruction. Among them 4 cases were found microeolon and narrowing of distal 1 cases of ileum at 1 cases of ileal atresia and 2 cases. 4. After operation, 26 of 30 cases were recovered but 3 cases (atsesia 1, stenosis 1, and hypoplasia 1) were discharged with complications. And 1 case of multiple ileal stencelsdied of sepsis and wound infection.
Constriction, Pathologic ; Female ; Humans ; Ileum* ; Intestinal Obstruction ; Male ; Meckel Diverticulum ; Parturition ; Sepsis ; Wound Infection

A case of cryptococal hepatitis in a 4-year-old girl was presented with a brief review of the literature. She was admitted with the chief complaints of jaundice, abdominal pain, and semicomatose mental state. Treatment was started including dexamethasone under impression of fulminant hepatitis. During treatment massive G-I bleeding appeared which required eleven pints of blood and 20 days for control. Upper G-I series revealed duodenal ucer. And explolparotomy was performed because of free air in the peritoneum. Operative liver biopsy done at that time revealed many cryptococci in the biopsy tissue. Therefore we treated her with-5-fluorocytosine and the result was good. Follow-up of her for a year and half revealed that she was in here good general condition. Therefore we consider that secondary change in liver such as cirrhosis has not yet occurred in her.
Abdominal Pain ; Biopsy ; Child, Preschool ; Dexamethasone ; Female ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Hepatitis* ; Humans ; Jaundice ; Liver ; Peritoneum

BACKGROUND/AIMS: The efficacy of standard triple therapy (STT) in treating Helicobacter pylori infection has decreased. Many investigators have attempted to increase the eradication rate. We investigated the outcomes of concomitant therapy (CT) and STT combined with probiotics (STP) as a first-line treatment for H. pylori infection. METHODS: We reviewed the medical records of 361 patients who received either STP (n=286) or CT (n=75). The STP group received STT combined with a probiotic preparation for 1 week. The CT group received STT and metronidazole for 1 week. RESULTS: The intention-to-treat and per-protocol eradication rates were 83.6% (95% confidence interval [CI], 79.0 to 87.7) and 87.1% (95% CI, 81.2 to 89.7) in the STP group and 86.7% (95% CI, 78.7 to 93.3) and 91.4% (95% CI, 83.6 to 97.1) in the CT group (p=0.512 and p=0.324), respectively. The frequency of adverse effects was higher in the CT group (28.2%) than in the STP group (12.8%) (p=0.002). CONCLUSIONS: STP and CT are encouragingly efficacious as first-line treatments for H. pylori infection. Therefore, adding probiotics to STT may be a feasible option to avoid side effects.
Helicobacter pylori* ; Helicobacter* ; Humans ; Medical Records ; Metronidazole ; Probiotics* ; Research Personnel

Purpose: Cone beam computed tomography (CBCT) is widely used to evaluate the temporomandibular joint (TMJ). For the three-dimensional (3D) assessment of the TMJ, segmentation of the mandibular condyle and articular fossa is essential. This study aimed to perform deep learning-based 3D segmentation of the mandibular condyle on CBCT images and evaluate the performance of the segmentation. Methods: CBCT scan data from 99 patients (mean age: 53.3±19.2 years) diagnosed with TMJ disorders were analyzed. From the CBCT images, sagittal, coronal, and axial planes showing the mandibular condyle were selected and combined to form two-dimensional (2D) images. The U-Net deep learning model was used to exclusively segment the mandibular condyle area from the 2D images. From these results, 3D images of the mandibular condyle were reconstructed. Accuracy, precision, recall, and the Dice coefficient were calculated to appraise segmentation performance in each plane. Results: The average Dice coefficient was 0.92 for the coronal and axial planes and 0.82 for the sagittal plane. The CBCT image-based segmentation performance of the mandibular condyle in the coronal and axial planes exceeded that in the sagittal plane. The sharpness and uniformity of the 2D images affected segmentation performance, with segmentation errors more likely occurring in non-uniform images. Certain segmentation errors were corrected through software processing. Finally, the segmented mandibular condyle images were applied to the CBCT data to reconstruct a 3D TMJ model. Conclusions Mandibular condyle 3D segmentation on CBCT images using U-Net may help evaluate and diagnose TMJ disorders. The proposed segmentation method may assist clinicians in efficiently analyzing CBCT images, particularly in cases involving anatomical abnormalities.

Collagenous colitis is an uncommon condition charaeterized clinically by diarrhea and weight loss and histologically by thickening of the subepithelial collagen band with chromic inflammation. Laboratory tests of blood, urine and stool, and colonscopic findings are usually normal. The etiology of collagenous colitis is unknown. We report a case of collagenous colitis improved after treatment with sulfasalazine with review of literatures.
Colitis, Collagenous* ; Collagen* ; Diarrhea ; Inflammation ; Sulfasalazine ; Weight Loss

OBJECTIVE: To investigate whether the polymorphism of Fas promoter gene is associated with susceptibility to systemic lupus erythematosus (SLE) and its clinical features. METHODS: Polymerase chain reaction of genomic DNA-restriction fragment length polymorphism using MvaI was used to determine genotypes of the Fas promoter in 87 SLE patients and 87 healthy control subjects. Clinical manifestations were analyzed in each patient and correlated with the genotypes. RESULTS: The genotype distribution of the Fas promoter did not differ between SLE patients and control subjects (AA, GA, GG genotypes 31.0%, 54.0%, 14.9% in SLE patients vs. 29.9%, 55.2%, 14.9% in controls respectively, chi2=0.03, 2 degrees of freedom, p=0.99). No significant differences were also found in allele frequencies between the groups. Clinically in the lupus patients according to the Fas promoter polymorphism, there were no significant differences in age at onset, anti-ds DNA titer, C3, C4 level, renal involvement, number of ACR (American College of Rheumatology) criteria presented, SLE Disease Activity Index, SLICC/ACR (The Systemic Lupus international Collaborating Clinics/American College of Rheumatology) damage index, and autoantibody profiles except for anti-RNP antibody. The frequency of anti-RNP antibody in the lupus patients was increased in AA group (71.4%) compared to GA and GG groups (26.2% and 30.0%, p=0.007). CONCLUSION: The Fas promoter polymorphism does not seem to confer susceptibility to SLE, but seems to have some influence on the development of certain autoantibody like anti-RNP antibody, suggesting that the Fas promoter polymorphism is functional.
DNA ; Freedom ; Gene Frequency ; Genotype ; Humans ; Lupus Erythematosus, Systemic* ; Polymerase Chain Reaction

OBJECTIVE: To investigate whether the polymorphism of Fas promoter gene is associated with susceptibility to systemic lupus erythematosus (SLE) and its clinical features. METHODS: Polymerase chain reaction of genomic DNA-restriction fragment length polymorphism using MvaI was used to determine genotypes of the Fas promoter in 87 SLE patients and 87 healthy control subjects. Clinical manifestations were analyzed in each patient and correlated with the genotypes. RESULTS: The genotype distribution of the Fas promoter did not differ between SLE patients and control subjects (AA, GA, GG genotypes 31.0%, 54.0%, 14.9% in SLE patients vs. 29.9%, 55.2%, 14.9% in controls respectively, chi2=0.03, 2 degrees of freedom, p=0.99). No significant differences were also found in allele frequencies between the groups. Clinically in the lupus patients according to the Fas promoter polymorphism, there were no significant differences in age at onset, anti-ds DNA titer, C3, C4 level, renal involvement, number of ACR (American College of Rheumatology) criteria presented, SLE Disease Activity Index, SLICC/ACR (The Systemic Lupus international Collaborating Clinics/American College of Rheumatology) damage index, and autoantibody profiles except for anti-RNP antibody. The frequency of anti-RNP antibody in the lupus patients was increased in AA group (71.4%) compared to GA and GG groups (26.2% and 30.0%, p=0.007). CONCLUSION: The Fas promoter polymorphism does not seem to confer susceptibility to SLE, but seems to have some influence on the development of certain autoantibody like anti-RNP antibody, suggesting that the Fas promoter polymorphism is functional.
DNA ; Freedom ; Gene Frequency ; Genotype ; Humans ; Lupus Erythematosus, Systemic* ; Polymerase Chain Reaction

Antiphospholipid antibody syndrome (APS) is defined as the presence of lupus anticoagulant antibody or anticardiolipin antibody with vascular thrombosis or pregnancy complications. APS can be associated with autoimmune disease or infectious disease. APS has also been reported in conjunction with variety of solid and hematologic malignancies. There were some reports on APS which were accompanied by hematologic malignancy, but there was no report with solid malignancy in Korea. We experienced one case of secondary APS, which was diagnosed during pre-operative evaluation of thyroid cancer. This patient had prolonged aPTT (activate partial thromboplastin time) and decreased coagulation factors which were regarded as hemophilia at first. Although the precise mechanism of the relationship between APS and cancer has not been proven thoroughly, APS can be accompanied by various malignancies. So proper screening and early detection of malignancies in APS patients are recommended.
Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome ; Autoimmune Diseases ; Blood Coagulation Factors ; Communicable Diseases ; Hematologic Neoplasms ; Hemophilia A ; Humans ; Korea ; Lupus Coagulation Inhibitor ; Mass Screening ; Pregnancy Complications ; Thromboplastin ; Thrombosis ; Thyroid Gland ; Thyroid Neoplasms

Systemic sclerosis is a multisystemic disease of unknown origin charicterized by degenerative fibrotic and inflammatory changes in the skin, vessels, joints, muscles, and visceral organs. Involvement of the lung in systemic sclerosis is common, but pleural effusion is rare. Although vasculitis commonly accompanies many connective tissue disorders, it has been rarely reported in systemic sclerosis. A 43-year-old woman, with a 10-year history of Raynaud's phenomenon, was admitted due to right chest pain. Her hands showed diffuse thickening and swelling of skin. Chest X-ray showed pleural effusions and esophageal manometry showed hypotonic peristalsis and low lower esophageal sphincter tone compatible with scleroderma esophagus. Antinuclear antibodies were present (titer >1: 160) with a speckled pattern She was positive for rheumatoid factor, anti scl-70 and RNP antibodies, but negative for anti-Ro, La, and Sm antibodies. Histology of the pleura revealed the presence of leukocytoclastic vasculits. After administration of prednisolone 30 mg/day, her chest symptom was improved. We report a case of systemic sclerosis with pleural effusions due to leukocytoclastic vasculitis with review of the literatures.
Adult ; Antibodies ; Antibodies, Antinuclear ; Chest Pain ; Connective Tissue ; Esophageal Sphincter, Lower ; Esophagus ; Female ; Hand ; Humans ; Joints ; Lung ; Manometry ; Muscles ; Peristalsis ; Pleura ; Pleural Effusion* ; Prednisolone ; Rheumatoid Factor ; Scleroderma, Systemic ; Skin ; Thorax ; Vasculitis*