The purpose of this study was to investigate that there was any differences of uptake ratio of Tc99-m-MDP during the healing process related to fracture level in tibia. Thirty mature rabbits were devided into three groups and each group consisted of ten rabbits. The osteotomy was performed at the proximal third of tibia in group I, at the middle third in group II and at the distal third in group III, respectively. After fracture was reduced, the fractured tibia was fixed with K-wire and immobilized with long leg cast. Serial Tc-99m-MDP scintigraphy with pixel counting method was performed in thirty cases of tibial shaft fracture from one day to eight weeks after fracture. The results obtained were as follows: l. In group I, the mean uptake ratio of Tc-99m-MDP at fracture site was 1.40±0.45 at two days after fracture, 3.34±1.21 at two weeks and increased rapidly to a maximal value of 7.51%1.01 at three weeks and decreased thereafter to 4.530.83 at eight weeks. 2. In group II, the mean uptake ratio was 1.10±0.10 at three days, 3.931.±10 at three weeks and increased rapidly to a maximal value of 7.37±2.21 at four weeks and decreased thereafter to 4.54±0.96 at eight weeks. 3. In group III, the mean uptake ratio was 1.13 ± 0.11 at three days, 3.95±0.93 at three weeks and increased rapidly to a maximal value of 7.43±1.72 at four weeks and decreased thereafter to 4.69±0.93 at eight weeks. These experiments suggest that the changes of Tc-99m-MDP scintigraphy in the proximal third fractures of tibia was earlier than middle or distal third fractures and there was no differences between middle and distal third fractures of the tibia.
Leg ; Methods ; Osteotomy ; Rabbits ; Radionuclide Imaging ; Tibia

OBJECTIVE: To evaluate possible variability in chest radiologists' interpretations of the Lung Imaging Reporting and Data System (Lung-RADS) on difficult-to-classify scenarios. MATERIALS AND METHODS: Ten scenarios of difficult-to-classify imaginary lung nodules were prepared as an online survey that targeted Korean Society of Thoracic Radiology members. In each question, a description was provided of the size, consistency, and interval change (new or growing) of a lung nodule observed using annual repeat computed tomography, and the respondent was instructed to choose one answer from five choices: category 2, 3, 4A, or 4B, or “un-categorizable.” Consensus answers were established by members of the Korean Imaging Study Group for Lung Cancer. RESULTS: Of the 420 answers from 42 respondents (excluding multiple submissions), 310 (73.8%) agreed with the consensus answers; eleven (26.2%) respondents agreed with the consensus answers to six or fewer questions. Assigning the imaginary nodules to categories higher than the consensus answer was more frequent (16.0%) than assigning them to lower categories (5.5%), and the agreement rate was below 50% for two scenarios. CONCLUSION: When given difficult-to-classify scenarios, chest radiologists showed large variability in their interpretations of the Lung-RADS categories, with high frequencies of disagreement in some specific scenarios.
Consensus ; Information Systems* ; Lung Neoplasms ; Lung* ; Mass Screening ; Surveys and Questionnaires ; Thorax

Multiple primary or secondary malignancies after anticancer therapy were recently reported to be increasing in frequency. The authors describe a case of metachronous metastatic pulmonary basaloid carcinoma to the central nervous system that was discovered after chemotherapy and radiation therapy for cervical uterine carcinoma. Two different types of cancer developed within some interval. There's the possibility that a secondary pulmonary neoplasm developed after the chemotherapy and radiotherapy conducted as cervical cancer treatment.
Central Nervous System ; Drug Therapy* ; Lung Neoplasms ; Neoplasm Metastasis* ; Neoplasms, Second Primary ; Radiotherapy ; Uterine Cervical Neoplasms

Hematopoietic stem cell transplantation is being widely used in an attempt to treat many hematological diseases such as leukemia, anemia, and lymphoma. To evaluate the success of hematopoietic stem cell transplantation, it is very important to determine how rapidly engraftment occurs. Therefore, this retrospective study was conducted to determine which factors affected the term of engraftment during hematopoietic stem cell transplantation, while focusing on the oral intake status. To accomplish this, 416 patients who underwent transplant operations at St. Mary's hospital from May 2006 to April 2008 were evaluated. The long-term engraftment group was characterized as having longer fasting days and more frequent vomiting, diarrhea, and oral mucositis incidences than the short-term engraftment group. In addition, the inhibitors of oral intake such as vomiting, diarrhea, and oral mucositis developed frequently between the pre-transplantation and 2 weeks after transplantation. A significantly negative correlation was observed between the oral intake volume and the duration of the oral intake inhibitors. A multiple regression analysis revealed that the frequency of vomiting and oral mucositis during hematopoietic stem cell transplantation, the length of hospitalization, and the hematocrit level in the 2 weeks after hematopoietic stem cell transplantation were significant predictors of engraftment. The results of this study could be used to establish a guideline for nutritional assessment, nutritional goals, and nutritional support for patients during hematopoietic stem cell transplantation.
Anemia ; Diarrhea ; Fasting ; Hematocrit ; Hematologic Diseases ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Hospitalization ; Humans ; Incidence ; Leukemia ; Lymphoma ; Nutrition Assessment ; Nutritional Status ; Nutritional Support ; Retrospective Studies ; Stomatitis ; Transplants ; Vomiting

Rate-dependent left bundle branch block during general anesthesia is rare, but its occurrence makes the electrocardiographic diagnosis of acute myocardial ischemia or infarction difficult. It can also be confused with slow rate ventricular tachycardia. Herein, a case of rate-dependent left bundle branch block, in a patient with no previous history of ischemic heart disease, is reported. The administration of esmolol resulted in a decrease in the heart rate, with reversion to normal sinus rhythm.
Anesthesia, General* ; Bundle-Branch Block* ; Diagnosis ; Electrocardiography ; Heart Rate ; Humans ; Infarction ; Myocardial Ischemia ; Tachycardia, Ventricular

Endobronchial lipomas are rare benign tumors that arise from the lung. They partially or totally obstruct the bronchial lumen, producing a variable degree of collapse, irreversible bronchiectasis, and pulmonary damage. Although bronchoscope, CT and MR are reported to be helpful in establishing the diagnosis, CT is highly specific and sensitive in detecting fatty tumor. They may be removed by endoscope or thoracotomy or lobectomy. We present a case of endobronchial lipoma completely obstructing the right middle lobe and postobstructive irreversible pulmonary change with review of literatures.
Bronchiectasis ; Bronchoscopes ; Diagnosis ; Endoscopes ; Lipoma* ; Lung ; Thoracotomy ; Thorax* ; Tomography, X-Ray Computed*

Bronchioloalveolar carcinoma is originated from the periphery of the lung and can be mistaken for lobar pneumonia or atypical pneumonia clinically and at gross examination. Recently the authors experienced a 67-year-old woman who had slowly progressed pulmonary lesions for four years. At first, she visited this hospital for intermittent chest pain four years before. And she visited other hospitals for the same problem and had a series of evaluation including two times of biopsy but did not have any conclusive diagnosis. With aggravation of chest pain, she was referred to this hospital again and the lesion was reexamined and confirmed as bronchioloalveolar carcinoma by ultrasonography-guided needle biopsy. Being performed left lower lobectomy, she kept good condition without any complication.
Adenocarcinoma, Bronchiolo-Alveolar ; Aged ; Biopsy ; Biopsy, Needle ; Chest Pain ; Diagnosis ; Female ; Humans ; Lung ; Pneumonia

Malignancies in congenital cystic adenomatoid malformations (CCAMs) of the lung are rare. We report a 41-year-old male patient with a pulmonary cystic lesion suspicious for CCAM, unrecognized until the patient was 40 years of age, and which subsequently became more consolidated during the interval between initial presentation and surgery. Microscopic examination of the resected specimen revealed features of type 1 CCAM with a mucinous adenocarcinoma, metastatic to the mediastinal lymph nodes. This case illustrates the importance of prompt surgical resection for all suspected CCAMs, especially those discovered in adulthood.
Adult ; Male ; Female ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

BACKGROUND: The purpose of this study was to compare the postoperative analgesic effects and side effects of an intra-articular PCA infusion of bupivacaine and morphine using an intravenous PCA infusion of morphine following arthroscopic shoulder surgery. METHODS: Seventy-one patients, undergoing arthroscopic shoulder surgery under general anesthesia, were randomly assigned to one of two groups. In group 1 (n = 32), morphine and ondansetron, 8 and 4 mg, respectively, were intravenously injected following surgery, with the subsequent infusion of normal saline 100 ml, including morphine and ondansetron, 32 and 12 mg, respectively, through an intra-venous PCA catheter. In group 2 (n = 39), 0.25% bupivacaine, 40 ml, including an intra-articular injection of morphine, 3 mg, followed by an infusion of 0.25% bupivacaine, 100 ml, including morphine, 5 mg, were administered through an intra-articular PCA catheter. In groups 1 and 2, the PCA infusion rate was 2 ml/h, with a bolus dose of 0.5 ml, with a lock out time of 8 min. The VAS for pain at rest, and the range of motion (ROM) exercise and side effects were assessed 0.5, 1, 2, 4, 12, 18 and 24 h postoperatively. RESULTS: The patients in group 2 had significantly lower VAS for pain for the ROM than those in group 1 30 min postoperatively. However, the VAS for pain at rest was significantly lower in group 1 than 2 after 18 and 24 h, but the VAS for pain for the ROM was significantly lower in group 1 than 2 24 h postoperatively. There was no significant difference in the side effects between the two groups, with the exception of dizziness, which was more severe in group 2 at 1, 2 and 4 h postoperatively. CONCLUSIONS: An intra-articular PCA infusion of bupivacaine and morphine is no more effective than an intra-venous PCA infusion of morphine and ondansetron with respect to postoperative analgesia and side effects.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia, General ; Bupivacaine ; Catheters ; Dizziness ; Humans ; Injections, Intra-Articular ; Morphine ; Ondansetron ; Passive Cutaneous Anaphylaxis ; Range of Motion, Articular ; Shoulder*

OBJECTIVE: Head injury is a leading cause of death and disability in subjects who suffer a traumatic accident. Contralateral hematomas after surgery for traumatic brain injury are rare. However, an unrecognized, these hematomas can cause devastating results. We presented our experience of these patients and discussed diagnosis and management. METHODS: This study included 12 traumatic patients with acute traumatic brain injury who developed delayed contralateral hematoma after evacuation of an acute hematoma. Clinical and radiographic data was obtained through review of medical records and radiographs retrospectively. RESULTS: Ten males and two females were included in the study. Ten (83.3%) patients had severe head injury (Glasgow Coma Scale [GCS] score <8). Intraoperative brain swelling during removal of the traumatic subdural hematoma was noted in 10 (83.3%) patients. A skull fracture on the side contralateral to the acute hematoma was noted on computed tomography (CT) scans of nine (75%) patients. Three (33.3%) patients with severe head injury (GCS <8) died. Only (10%) one patient with a severe head injury had less severe disability. CONCLUSION: A postoperative CT scan is essential in patients with acute traumatic brain injury and a contralateral skull fracture or a low GCS score. Our results indicated that it is very important to evaluate this rare but potentially devastating complication.
Brain Edema ; Brain Injuries* ; Cause of Death ; Coma ; Craniocerebral Trauma ; Craniotomy ; Decompressive Craniectomy ; Diagnosis ; Female ; Hematoma* ; Hematoma, Subdural ; Humans ; Male ; Medical Records ; Postoperative Hemorrhage ; Retrospective Studies ; Skull Fractures ; Tomography, X-Ray Computed