One of the patellar function is to protect the femoral condyle from direct blowing to knee, so it is known that ligament injuries of the knee are rare in the presence of patellar fracture. We experienced four cases of posterior cruciate ligament injury associated with patellar fracture. Unfortunately, three cases were initially neglected, and one case was identified by visualization on avulsed posterior tibial spine in plain X-ray film. We reviewed these cases and obtained several results as follows; 1. Among four cases, three cases(75%) are fractured at the lower pole of patella without displacement and one case is a longitudinal fracture. 2. We consider possible two mechanisms of this injury; first, in flexed knee, posteriorly directed force on the proximal tibia produces posterior cruciate ligament injury followed by avulsed fracture at the lower pole of patella. Second, by fall on a flexed knee, the load is sustained on the inferior pole of the patella first and continuously drives the tibia backwards producing posterior cruciate ligament injury. We recommend that all surgeon should be aware of possibility of the ligament injury in the presence of patellar fracture, especially in lower pole fracture.
Knee ; Ligaments ; Patella ; Posterior Cruciate Ligament ; Spine ; Tibia ; X-Ray Film

Hepatoblastoma (HB) is a rare embryonic malignant tumor of the liver. Most morphological studies on HB have limited to the histological characteristics and only 3 cases of HB have been described in the cytology literature. We present 2 cases of HB occurring in children aged 1 year and 3 years, respectively. The distinctive cytologic features of fine needle aspiration of HB were clusters of tumor cells showing acinar and trabecular pattern, smaller tumor cells with a high nuclear-cytopalsmic ratio and hyperchromatic nuclei having prominent nucleoli, and the presence of extramedullary hematopoiesis and osteoid material. These features were also found in the cell block and the biopsy specimen, and appeared very useful in the differentiation of HB from hepatocellular carcinoma.
Acute Kidney Injury* ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Child* ; Hematopoiesis, Extramedullary ; Hepatoblastoma ; Humans ; Liver ; Nephrosis, Lipoid*

To determine the frequencies of the genotypes of NAT2 gene in healthy Korean populations and to identify the high-risk genotypes of NAT2 gene in colorectal cancer patients, 115 healthy controls and 109 cancer patients were analyzed using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). The distribution of NAT2 polymorphism in healthy Korean was found to be 7.8% of S/S genotype, 48.7% of S/F genotype, and 43.5% of F/F genotype. And the frequency of phenotypes was 8% of slow acetylator and 92% of rapid acetylator. S/S genotype of colorectal cancer patients was slightly more frequent than that of healthy controls(11.9% vs 7.8%). The relative risk of S/S genotype to colorectal cancer was estimated to be 1.41, taking the risk of F/F genotype as a baseline(1.00). These results suggest that the distribution of frequencies of NAT2 genotypes is very unique in Korean characterized by extremely low frequency of slow acetylator geno type(S/S) in comparison to the other ethnic groups. And the slow acetylator genotype(S/S) in Korean was found to be more susceptible to colon cancer. Therefore, S/S genotype may have a certain role an colonic carcinogenesis in Korean.
Carcinogenesis ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Ethnic Groups ; Genetic Predisposition to Disease* ; Genotype ; Humans ; Korea* ; Phenotype

BACKGROUND: To investigate how many rookie pitchers suffered from injuries while playing in the amateur league without guidelines for prevention of excessive pitching, we analyzed their amateur pitching patterns based on the pitch count, use of breaking balls, and pitches during winter camp. METHODS: Forty-one rookie pitchers who graduated from high school or university in 2013 and joined professional baseball teams. Participants were interviewed by a trainer using our questionnaire. Injury inclusion criteria were 1) history of shoulder surgery, 2) history of elbow surgery, 3) shoulder pain requiring treatment, and 4) elbow pain requiring treatment. RESULTS: Mean number of pitches per game and warm-up pitches for practice was 84.5 pitches (range, 15 to 130 pitches) and 16.4 pitches (range, 2 to 210 pitches), respectively. Mean number of pitches during the last year was 906.9 (range, 80 to 2,000). Mean number of maximal pitches was 127 pitches (range, 50 to 210 pitches). Fourteen pitchers had pitched over 150 pitches. Twenty-seven pitchers (65.9%) had pitched in spite of enduring pain. During winter training (mean 1.8 months), mean number of pitches per day was 162.5 pitches, and 20 pitchers (48.8%) had practiced pitching excessively despite the cold weather. Twenty-six rookies (63.4%) had shoulder pain or history of shoulder surgery, and 31 pitchers (75.6%) had elbow pain or history of elbow surgery. Only four participants (9.8%) did not have pain and history of surgery. CONCLUSIONS: For young baseball pitchers, guidelines for prevention of excessive pitching and for regulating the winter training program may be needed.
Baseball* ; Education ; Elbow* ; Humans ; Shoulder Pain ; Shoulder* ; Weather

Endometriosis in the abdominal wall following Cesarean section is one of the very rare condition among the extrapelvic endometriosis. Although benign, endometriosis possesses the unique ability to invade tissue and to disseminate or metastasize by hematogeneous, lymphatic route, or direct implantation. We reported the case with brief review of the literature.
Abdominal Wall* ; Cesarean Section* ; Endometriosis* ; Female ; Pregnancy

Vibrio parahaemolyticus is a gram-negative halophilic organism commonly associated with outbreaks of acute gastroenteritis which also sometimes causes serious wound infection. It is an uncommon cause of bacteremia. We have experienced a case of bacteremia due to Vibrio parahaemolyticus in a 59-year old man who initially presented with edema and dyspnea. He was diagnosed as liver cirrhosis, gastric cancer, and hepatoma. On hospital day 13, Vibrio parahaemolyticus was isolated from blood culture. The isolate showed typical cultural and biochemical characteristics such as salt tolerance and did not ferment lactose. The isolate was intermediate to ampicillin but susceptible to other agents.
Ampicillin ; Bacteremia* ; Carcinoma, Hepatocellular ; Disease Outbreaks ; Dyspnea ; Edema ; Gastroenteritis ; Humans ; Lactose ; Liver Cirrhosis ; Middle Aged ; Salt-Tolerance ; Stomach Neoplasms ; Vibrio parahaemolyticus* ; Vibrio* ; Wound Infection

We report a cace of 69-year-old man who developed massive pulmonary hemorrhage and subsuquent adult respiratory distress syndrome following intravenous urokinase for acute myocardial infarction. Pulmonary hemorrhage is a rare but a potentially life-threatening complication after thrombolytic therapy and should be considered in the differential diagnosis of pulmonary infiltrates of falling hemoglobin after thrombolytic therapy for acute myocardial infarction with no obvious site of bleeding.
Adult* ; Aged ; Diagnosis, Differential ; Hemorrhage* ; Humans ; Myocardial Infarction* ; Respiratory Distress Syndrome, Adult* ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator

No abstract available.
Pancreaticoduodenectomy*

In our series with old electrical burn around the the wrist, there are several characteristics: for example, bad scarring in palm and volar aspect of wrist and distal forearm, large multiple defects of the flexor tendons, low median and ulnar nerve palsy, and occasionally insufficient blood supply. Between 1992 and 1995, we treated 8 cases of 7 patients with staged reconstruction. 4 patients with bilateral involvements had below-elbow amputee of contralateral upper extremity. The common approachs in each were soft tissue coverage, staged tendon reconstructiuon, and opponensplasty. The length of time between the injury and tendon reconstruction was 9 months on an average. Soft tissue coverage consisted of: 1. free tissue transfer (n=3), 2. abdominal (n=3) or groin (n=2). Total numbers of flexor tendon reconstruction were 26. Among them, staged reconstruction using silicone prosthesis were done in 18 tendons and primary tendon graft following tenolysis were done in 8 tendons. The time between first and second stage tendon reconstruction was 4.13 months. In all cases, opponen-splasty using extensor indicis proprius (n=4), extensor pollicis longus (n=2), and extensor digiti mini- mi (n=l), were performed. Good functional improvement of the hand were obtained in all cases. Patient s satisfaction were much better than the degree of functional improvement of the hand.
Amputees ; Burns* ; Cicatrix ; Forearm ; Groin ; Hand ; Humans ; Prostheses and Implants ; Silicones ; Tendons ; Transplants ; Ulnar Neuropathies ; Upper Extremity ; Wrist*

The purpose of this research is to find out the degree of cartilage regeneration by inserting the atelo- collagen scaffold obtained from dermis of a calf on cartilage defect site. Dissection underneath the perichondrium by the periosteal elevator on both side of ears of six New Zealand white rabbits were made to expose the cartilage, leaving pairs of circular holes 3, 6, 9 mm width with punches. One hole was left for a control, and on the other hole atelo-collagen scaffold of the same size was transplanted. In postoperative 1, 2, 4 weeks, the tissues were dyed. The length of long axis of neocartilage was measured through an optical microscope with a 0.1mm graduation at original magnification, x40. In the first and second week, both group showed no sign of cartilage regeneration. In the fourth week, regeneration on marginal portions was observed on all groups and the average values of length of long axis of neocartilage according to defect size were as follows: In the cases with 3mm defect, it was 0.85+/-0.30mm in the control group, and 1.85+/-0.38mm in the graft group; in the cases with 6 mm defect, 1.33+/-0.58mm in the control group, and 2.25+/-0.46mm in the graft group; and in the cases with 9mm defect, 2.33+/-0.77mm in the control group, and 4.47+/-1.39mm in the graft group. This means that the collagen scaffold has an influence on the regeneration of neocartilage. But the relative ratio of the length of neocartilage to cartilage defect size was not significant in the statistics.
Axis, Cervical Vertebra ; Cartilage* ; Collagen ; Collagen Type I* ; Dermis ; Ear ; Elevators and Escalators ; Rabbits ; Regeneration ; Transplants