A major problem in the repair of the torn Achilles tendon has been providing the restoration of the anatomic continuity such that virtually normal plantar flexion power and ankle mobility result. Continuity should be restored without subsequent pain, disconfiguration, occupational limitations. If possible, postoperative complications, or tendon-rerupture should be avoided. Surgeons have long advocated the use of strips of facia and other tissues, including the plantaris tendon, to reinforce the repair of the torn Achilles tendon, The repair effected by these methods not infrequently is bulky and not too secure. Non-absorbable suture materials utilizing in the end to end anastomosis of the torn Achilles tendon cause sinus formation and discharge of suture materials. A secure method of repair for the tom Achilles tendon, which decreases sinus formation and is not bulky, should be required. The plantaris tendon, which has been used as a reinforcing material, can be utilized in the end-to-end anastomosis of the torn Achilles tendon by detaching from the muculotendinous junction. The 11 patients with the torn Achilles tendon were treated by end-to-end anastomosis using the plantaris tendon as suture material. The postoperative results were staisfactory without significant functional deficit and complication.
Achilles Tendon ; Ankle ; Humans ; Methods ; Postoperative Complications ; Surgeons ; Sutures ; Tendons

Lawsonia intracellularis is not culturable with a standard bacteriologic culture. One step PCR assay as a clinical diagnostic method was developed for the rapid detection of porcine proliferative enteritis (PPE) caused by L. intracellularis. Primers were designed based on the p78 DNA clone of L. intracellularis. The one step PCR resulted in the formation of a specific 210-bp DNA product derived from L. intracellularis. The nonspecific amplification product was not detected with swine genomic DNA or other bacterial strains causing similar symptoms to L. intracellularis infection. The one step PCR was as sensitive as 100 pg of L. intracellularis genomic DNA. We applied this method to field specimens diagnosed as PPE by macroscopic observation. Of 17 mucosal scraping specimens, 16(94%) were identified as positive to PPE and 15(88%) of 17 feces specimens. These results suggest that the one step PCR can be used as a rapid diagnostic method for L. intracellularis infection.
Animals ; Base Sequence ; DNA Primers ; Desulfovibrionaceae Infections/diagnosis/*veterinary ; Ileum/microbiology/pathology ; Intestinal Mucosa/microbiology/pathology ; Lawsonia Bacteria/genetics/*isolation & purification ; Polymerase Chain Reaction/*methods ; Reproducibility of Results ; Sensitivity and Specificity ; Swine ; Swine Diseases/*diagnosis/microbiology

BACKGROUND: Multiple approaches for nipple reconstruction exist, and none is considered superior to all others. The star flap is one of the most popular methods for nipple reconstruction, but gradual height loss is a major concern. We present a new modification of the star flap that incorporates a de-epithelialized dermal flap, along with the associated surgical results. METHODS: We reviewed the medical records of patients who underwent nipple reconstruction using the modified star flap method. The design was different from the conventional star flap in that the lateral wings were changed into a trapezoidal shape and de-epithelialized dermal flaps were added. The patients were followed up at 2, 4, 6, and 12 months postoperatively, and nipple height was measured. The postoperative nipple height achieved using the modified method was compared with that obtained using the traditional method. RESULTS: From February 2013 to June 2017, 32 patients received surgery using the modified star flap, and 18 patients who underwent nipple reconstruction before 2013 comprised the conventional method group. All patients had undergone breast reconstruction with an abdominal tissue-based flap. The mean follow-up period was 14.4 months in the modified method group and 17.3 months in the conventional method group. The mean maintenance of projection at 12 months postoperatively was 56.28%±18.58% in the modified method group, and 44.23%±14.15% in the conventional method group. This difference was statistically significant (P<0.05). CONCLUSIONS: The modified method using a de-epithelialized dermal flap provides reliable maintenance of projection in patients who have undergone abdominal tissue-based breast reconstruction.
Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Medical Records ; Methods ; Nipples ; Surgical Flaps

Interstitial cells of Cajal (ICC) are the pacemalkers in gastrointestinal muscles, and these cells also mediate or transduce inputs from the enteric nervoius system. Immunolabelling of interstitial cells of ICC in intestinal wall is recently developed by using specific marker, anti-c-kit antibody. Immunohistochemistry was done for c-Kit-positive ICC network in attempt to provide a morphological basis for the mechanism regulating gastro-intestinal movement. Cryosection and whole-mount preparations of mouse ileum and colon were immunolabelled using the anti-c-Kit. Immunolabelled specimens were observed under a confocal laser scanning microscopy. According to three dimensional reconstruction study, it was found that the c-Kit-positive cells were widely distributed in the intestinal wall: (1) circular muscle layer, (2) myenteric plexus, (3) deep muscular plexus in ileum, (4) submucosal plexus and longitudinal muscle layer in colon. The characteristic profiles of ICC containing c-Kit-positive cells provide a morphological basis upon the mechanism regulating gastro-intestinal motility.
Animals ; Colon ; Ileum ; Immunohistochemistry ; Interstitial Cells of Cajal* ; Intestines* ; Mice* ; Microscopy, Confocal ; Muscles ; Myenteric Plexus ; Submucous Plexus

Background: The coronavirus disease 2019 (COVID-19) has reportedly affected almost 23 million people, with more than 800 thousand deaths globally. There have been a few reports on the ocular manifestations of COVID-19 patients in China but no reports in Korea. The present study aimed to examine ocular manifestations of COVID-19 patients in Korea. Methods: COVID-19 patients admitted from March 2020 to April 2020 at Keimyung University Dongsan Hospital and Keimyung University Daegu Dongsan Hospital were reviewed retrospectively for ocular manifestations. During the period of hospitalization, ocular symptoms as well as blood test results were noted and analyzed. Patients were then divided into the first-episode and relapsed group and ocular symptoms were analyzed in the groups. Results: A total of 103 patients were included in this study. Among them, 71patients were in the first-episode group and 32 patients in the relapsed group. No significant differences were determined in terms of positivity of ocular symptoms between the first-episode group (12 patients, 16.9%) and the relapsed group (10 patients, 31.3%, p > 0.05). Symptoms of positive upper respiratory infection and lower creatine phosphokinase were determined to be related to positive ocular symptoms. Conjunctival congestion was noted in seven patients. In the subgroup analysis, the conjunctival congestion-positive patients exhibited higher positivity of upper respiratory infection symptoms (100%) as compared with those in the negative group (40%, p = 0.017). Conclusion Positive upper respiratory infection symptoms and lower creatine phosphokinase were determined to be related to ocular symptoms in COVID-19 patients.Among these patients, positive upper respiratory infection symptoms were associated with conjunctival congestion.

Pseudo-Meigs' syndrome is a syndrome that includes hydrothorax and ascites secondary to ovarian tumors other than solid benign fibroma. In this report, we present the case of a 29-years-old female who complained of abdominal distension with peripheral edema during her third trimester. Two solid masses of 15 cm dimension in the left abdomen and 7 cm dimension in the right abdomen were detected by ultrasound and chest X-ray revealed right pleural effusion. Magnetic resonance imaging (MRI) confirmed the ovarian masses and ascites. As the patient had regular uterine contractions, we decided to perform emergency cesarean section because of previous cesarean section history. A laparotomy was performed and pathologists confirmed the presence of a metastatic adenocarcinoma. Four days following the surgery, gastroduodenoscopy revealed a huge ulcerofungating mass was visible in greater curvature of stomach. The final diagnosis was metastatic adenocarcinoma from gastric cancer. Although pseudo-Meigs' syndrome is very rare, it should be carefully considered when evaluating female complaining with ascites in ovarian tumor.
Abdomen ; Adenocarcinoma ; Ascites ; Cesarean Section ; Edema ; Emergencies ; Female ; Fibroma ; Humans ; Hydrothorax ; Laparotomy ; Magnetic Resonance Imaging ; Pleural Effusion ; Pregnancy ; Pregnancy Trimester, Third ; Stomach ; Stomach Neoplasms ; Thorax ; Uterine Contraction

BACKGROUND: Absorbable materials offer many advantages in the reconstruction of orbital walls; however, the possibility of postoperative enophthalmos after complete absorption cannot be excluded. We evaluated the postoperative results of absorbable mesh plates used as onlay implanting on the medial orbital wall to determine whether they are suitable for medial orbital wall reconstruction. METHODS: The study included 20 patients with medial orbital wall fractures who were followed up for more than 2 years postoperatively. We used absorbable mesh plates in all of the patients. We measured the following: the changes in the expanded orbital volume by comparing the preoperative and postoperative computed tomography (CT) scans and the degree of clinical enophthalmos. RESULTS: There were no major complications associated with the use of absorbable materials such as infection, migration, or extrusion of mesh plates during the long-term follow-up. The orbital volumetric changes between the preoperative and postoperative CT scans were not statistically significant. However, the expanded orbital volume was not related to the degree of clinical enophthalmos. CONCLUSIONS: The reconstructed orbital wall may provide supportive scar tissue to the orbital contents even after the absorbable materials have dissolved completely. Absorbable mesh plates could be another option for the reconstruction of the medial orbital wall.
Absorbable Implants ; Absorption ; Cicatrix ; Enophthalmos ; Follow-Up Studies* ; Humans ; Inlays ; Orbit* ; Orbital Fractures

Implantable cardioverter-defibrillator (ICD) therapy is acknowledged as a valid treatment method for the effective prevention of sudden cardiac death, which is a major cause of mortality in adult congenital heart disease patients. But ICD implantation by the conventional transvascular approach is not always possible in patients who have undergone palliative surgery due to congenital and structural heart disease. Here, we report a case in which an ICD was transvascularly implanted in an arrhythmogenic right ventricular cardiomyopathy patient who had undergone a one-and-a-half ventricle repair.
Adult ; Arrhythmogenic Right Ventricular Dysplasia ; Death, Sudden, Cardiac ; Defibrillators, Implantable* ; Fontan Procedure ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Mortality ; Palliative Care

A primary benign schwannoma of the liver is extremely rare. Only nine cases have been reported in the medical literature worldwide and no case has been reported in Korea previously. A 36-yr-old woman was admitted to our hospital with vague epigastric pain. The ultrasound and computed tomography scan revealed a multiseptated cystic mass in the right lobe of the liver. The mass was resected; it was found to be a 5x4x2 cm mass filled with reddish yellow fluid. The histological examination confirmed the diagnosis of a benign schwannoma, proven by positive immunoreaction with the neurogenic marker S-100 protein and a negative response to CD34, CD117 and smooth muscle actin. This is the first report of a benign schwannoma of the liver parenchyma in a Korean patient.
Adult ; Antigens, CD34/analysis ; Female ; Humans ; Liver Neoplasms/diagnosis/*pathology ; Neurilemmoma/diagnosis/*pathology ; Proto-Oncogene Proteins c-kit/analysis

BACKGROUND: A brief episode of global forebrain ischemia produces selective and often extensive neuronal loss in several vulnerable brain structures. This cell death does not occur immediately, but is delayed for hours to days. This process is termed delayed neuronal death (DND). Recently, several reports have suggested that an apoptotic process may be involved in DND. The most effective treatment at present is intraischemic hypothermia. Thus, we designed this study to investigate whether intraischemic mild hypothermia could inhibit apoptosis following transient forebrain ischemia in gerbils. METHODS: Twenty-four gerbils were divided into two groups based on intraischemic rectal temperature: 34 degrees C(n=12) and 37 degrees C(n=12). Two additional gerbils underwent a sham operation. Cerebral ischemia was produced by occluding both carotid arteries for 10 minutes. The DNA fragmentation in the gerbil hippocapal CA1 area was determined by using the TUNEL method, and the results for the normothermic and the hypothermic groups were compared at 1, 3, and 7 days following 10-min transient ischemia (n=4 for each time point, respectively). RESULTS: 1. Percent dead hippocampal neurons were significantly decreased in the hypothermic group compared with the normothermic group at 1, 3, and 7 days following transient ischemia (p<0.05). 2. In the intraischemic normothermic group, TUNEL positive cells were first detected in the hippocampal CA1 at 3 days (1.9+/-0.6 cells/section), and the number was larger at 7 days following transient ischemia (127.8+/-16.3 cells/section). 3. In the intraischemic hypothermic group, no TUNEL positive cells were detected in the hippocampal CA1 at 1, 3, and 7 days following transient ischemia. CONCLUSION: The data suggest that delayed neuronal death following transient ischemia is, in part, apoptotic and that intraischemic mild hypothermia affords significant neuronal protection and prevents DNA fragmentation.
Apoptosis* ; Brain ; Brain Ischemia ; Carotid Arteries ; Cell Death ; DNA Fragmentation ; Gerbillinae* ; Hypothermia* ; In Situ Nick-End Labeling ; Ischemia* ; Neurons ; Prosencephalon*