No abstract available.

The purpose of this study is to evaluate the ventricular conduction abnormalities, especially RBBB, observed electrocardiographically after surgical closure of VSD. The present study population consists of 92 patients with VSD who were surgically corrected at the Hanyang University Hospital during 6 years period from Jan. 1985 to Dec. 1990. We reviewed their clinical records including surgical notes and EKG findings before and after operations. The results of the study were as follows: 1) Male to female ratio was 1.1:1 (48:44) 2) Out of a total of 92 cases of VSD, 65cases(70.7%)were perimembranous type and 27 cases (29.3%)were subarterial type. 3) The normal preoperative EKG findings were seen in 22 patients, LVH in 21 patients, BUH in 47patients, and RVH in 3 patiens. 4) A transatrial approach was performed in 55 cases, right ventriculotomy with or without resection of muscles in right ventricle in 13 cases, and pulmonary arteriotomy alone in 24 cases. 5) The right bundle branch block after operation developed in 33 patients out of the 65 patinets with perimembranous defect and 5 patients out of the 27 patients with subarterial defects. Postoperative RBBB developed more frequently in perimembranous defect than in subarterial defect. 6) Postoperative RBBB occured in 31.8% of the patients with normal preoperative EKG findings, 23.8% with preoperative LVH, 52.1% with BVH and 66.7% with RVH. Postoperative RBBB was more frequently observed in the patients group with preoperative BVH or RVH than the patients with normal or LVH. 7) Postoperative RBBB was observed in 84.6% after right wentriculotomy, in 43.6% after right atriotomy and in 12.5% with pulmonary arteriotomy alone.
Bundle-Branch Block* ; Electrocardiography ; Female ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans ; Male ; Muscles

PURPOSE: To report variable radiologic manifestastions and to accomplish detailed radiologic-pathologic correlation of solid and papillary epithelial neoplasm of the pancreas. MATERIALS AND METHODS: In 23 patients with surgically confirmed solid and papillary epithelial neoplasm, retrospective examinations of operative records, gross and micropathologic findings, and radiologic findings including US(n=17), CT(n=23), ERCP(n=9), MRI(n=3) were carried out. On the basis of pathologic findings, detailed analysis of radiologic findings of solid and papillary epithelial neoplasm was then performed. RESULTS: Most pancreatic solid and papillary epithelialneoplasms(n=17) were seen as a mass with heterogeneous internal density consisting of cystic change, hemorrhagicnecrosis, and tumor tissue, although the mass can also be seen to be homogeneous(n=6). On gross specimens, acapsule which showed enhancement on the delayed phase of the enhanced CT scan was demonstrated in 22 cases. It was seen as an echogenic rim on the ultrasound images and as a low signal rim on the MR images. Calcification of themass was seen in ten cases, nine of which showed peripheral calcification along the tumor capsule ; five cases showed calcifications within the mass. On pathologic examination, ten cases had a single or multiple cystic appearance ; in seven of these cases, this appeared on CT scan. CONCLUSIONS: In addition to usual mixed internal density caused by hemorrhagic necrosis of the tumor, enhanced capsule and internal multicystic appearance on CT scan were other characteristics of pancreatic solid and papillary epithelial neoplasm. These could be useful findings in the radiologic approach and in the differential diagnosis of pancreatic masses.
Diagnosis, Differential ; Necrosis ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography

Glomus tumors are maturely organized proliferations of glomus cells and vascular channels. Such tumors are rare in the stomach, and only two cases have been reported in Korea. Because specific clinical or radiologic features are not associated with the glomus tumor, it can be recognized only by histologic characteristics. Although available data are inadequate for determining the histogenesis of this tumor, it may represent a hamartoma rather than a neoplastic disease. The treatment of choice is local resection. In frozen sections, it may be misidentified as a carcinoid tumor, leading to more extensive surgery than required for cure. We report a case of a glomus tumor of the stomach in a 30-year-old female patient who was operated on, and we present a review of the literature on this subject.
Adult ; Carcinoid Tumor ; Female ; Frozen Sections ; Glomus Tumor* ; Hamartoma ; Humans ; Korea ; Stomach*

Glomus tumors are maturely organized proliferations of glomus cells and vascular channels. Such tumors are rare in the stomach, and only two cases have been reported in Korea. Because specific clinical or radiologic features are not associated with the glomus tumor, it can be recognized only by histologic characteristics. Although available data are inadequate for determining the histogenesis of this tumor, it may represent a hamartoma rather than a neoplastic disease. The treatment of choice is local resection. In frozen sections, it may be misidentified as a carcinoid tumor, leading to more extensive surgery than required for cure. We report a case of a glomus tumor of the stomach in a 30-year-old female patient who was operated on, and we present a review of the literature on this subject.
Adult ; Carcinoid Tumor ; Female ; Frozen Sections ; Glomus Tumor* ; Hamartoma ; Humans ; Korea ; Stomach*

PURPOSE: Tuberculosis (TB) is mainly caused by Mycobacterium tuberculosis, which is a pathogenic mycobacterial species grouped under Mycobacterium tuberculosis complex (MTBC) with four other pathogenic mycobacterial species. The mycobacteria not included in MTBC are known as nontuberculous mycobacteria (NTM), and cause several pulmonary diseases including pneumonia. Currently, NTM occurrences in TB-suspected respiratory specimens have increased, due to which, precise detection of MTBC and NTM is considered critical for the diagnosis and vaccination of TB. Among the various methods available, real-time PCR is frequently adopted for MTBC/NTM detection due to its rapidness, accuracy, and ease of handling. In this study, we evaluated a new real-time PCR kit for analytical and clinical performance on sputum, bronchial washing, and culture specimens. MATERIALS AND METHODS: For assessing its analytical performance, limit of detection (LOD), reactivity, and repeatability test were performed using DNA samples. To evaluate clinical performance, 612 samples were collected and clinically tested at a tertiary hospital. RESULTS: LOD was confirmed as 0.584 copies/µL for MTBC and 47.836 copies/µL for NTM by probit analysis (95% positive). For the reactivity test, all intended strains were detected and, in the repeatability test, stable and steady results were confirmed with coefficient of variation ranging from 0.36 to 1.59. For the clinical test, sensitivity and specificity were 98.6%–100% and 98.8%–100% for MTBC and NTM, respectively. CONCLUSION: The results proved the usefulness of the kit in TB diagnosis. Furthermore, it could be adopted for the assessment of vaccine efficacy.
BCG Vaccine ; Diagnosis ; DNA ; Limit of Detection ; Lung Diseases ; Mycobacterium tuberculosis ; Nontuberculous Mycobacteria ; Pneumonia ; Real-Time Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum ; Tertiary Care Centers ; Tuberculosis ; Vaccination*

Type 2 diabetes (T2D) is a progressive disease in which it is challenging to achieve long-term durable glycemic control. However, intensive glycemic control is crucial for preventing diabetes-related complications. Previous studies showed that monotherapy with a stepwise add-on approach was seldom effective for long-term durable glycemic control. Combination therapy, which refers to the use of two or more drugs to control hyperglycemia, has multiple benefits, including the ability to target a variety of pathophysiological processes underlying hyperglycemia. In clinical trials, initial combination therapy showed better glycemic control than monotherapy or a stepwise approach. Emerging evidence indicates that initial combination therapy is associated with preserved β-cell function and fewer complications in T2D. However, cost-effectiveness and adverse events with combination therapy are issues that should be considered. Therefore, initial combination therapy is an important option for patients with T2D that clinicians should consider with a view toward balancing benefits and potential harms. In this review, we summarize the literature addressing initial combination therapy in T2D, and we suggest optimal strategies based on clinical situations and patient characteristics.

PURPOSE: To understand the relationship between tibial bone defect and extent of medial release in total knee arthroplasty. MATERIALS AND METHODS: We evaluated 32 knees in 22 patients with variable degrees of tibial bone defect on medial plateau has undergone total knee arthroplasty. In this study, 31 cases had been diagnosed as degenerative osteoarthritis and 1 case was osteonecrosis. We excluded cases with infection, traumatic arthritis, or neuropathic joints. With regard to gender, 29 cases were female and 3 cases were male. The following relationships were analyzed: preoperative degrees of tibial bone defect and varus deformity; the femorotibial angle of both weight-bearing whole extremity radiogram, distractive stress radiogram, and the extent of medial release. RESULTS: Average tibial bone defect was 9.8+/-4.1 mm. Average femorotibial angle on weight-bearing whole extremity radiograph was varus 10.0degrees+/-6.2degrees. Average femorotibial angle on distractive stress radiograph was varus 0.7degrees+/-4.6degrees. Statistically the extent of medial release showed no significant relationship with the degree of tibial bone defect and femoro-tibial angle of whole extremity radiogram. However, it revealed a statistically significant relationship with the femorotibial angle on distractive radiogram (r=0.465, p=0.007). CONCLUSIONS: Preoperative distractive stress radiograph might be a useful method to predict the extent of intraoperative medial release during total knee arthroplasty.
Arthritis ; Arthroplasty ; Extremities ; Female ; Humans ; Joints ; Knee ; Male ; Osteoarthritis ; Osteonecrosis ; Weight-Bearing

PURPOSE: The primary purpose of this study was to demonstrate that the TRIGEN™ INTERTAN nail (InterTAN) could show better clinical outcome compared to the proximal femoral nail antirotation 2 (PFNA2) for treatment of intertrochanteric fracture in the elderly. MATERIALS AND METHODS: Between March 2009 and December 2013, 164 patients with intertrochanteric fractures who met our inclusion and exclusion criteria were enrolled in this study. Evaluation variables, including operation time, blood loss during the operation, incidence of perioperative complications, clinical results at the last follow-up, and radiographic findings were assessed for comparison of the 2 implants. RESULTS: Intraoperative lateral wall fracture was significantly higher in the PFNA2 group (p<0.05) and tip apex distance was significantly higher in the InterTAN group (p<0.05). Sliding of the proximal fragment at the last follow-up was significantly higher in the PFNA2 group. However, there was no significant difference in union rate, time to union, postoperative complications, and clinical outcomes at the last follow-up between the 2 groups. CONCLUSION: Based on these data, clinical outcomes at the last follow-up were equivalent between InterTAN and PFNA2.
Aged ; Follow-Up Studies ; Hip Fractures* ; Humans ; Incidence ; Postoperative Complications