Brentuximab vedotin (BV), a potent antibody-drug conjugate, targets the CD30 antigen. Owing to the remarkable efficacy shown in CD30-positive lymphomas, such as Hodgkin's lymphoma and systemic anaplastic large-cell lymphoma, BV was granted accelerated approval in 2011 by the US Food and Drug Administration. Thereafter, many large-scale trials in various situations have been performed, which led to extensions of the original indication. The aim of this review was to describe the latest updates on clinical trials of BV and the in-practice guidance for the use of BV.
Antigens, CD30 ; Financing, Organized ; Hodgkin Disease ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; United States Food and Drug Administration

PURPOSE: This study evaluated the results of acetabular medial wall osteotomy to reconstruct the acetabulum in dysplastic hip during total hip arthroplasty. MATERIALS AND METHODS: We clinically and radiologically evaluated 30 hips of 30 patients with secondary hip osteoarthritis caused by congenital hip dislocation or acetabular dysplasia who underwent total hip arthroplasty (THA) between March 1999 and October 2002. The average age of subjects was 46.5 years(17 to 73 years), and the mean follow-up period was 5 years(5.3 to 8.7 years). In 26 cases, a cementless hemispherical acetabular cup was inserted in the true acetabulum; in 4 cases a reinforced ring was inserted. Only 2 hips needed structural bone grafting. RESULTS: The average Harris hip score improved from 56.3 points preoperatively to 93.2 points at the last follow up. Radiographic analysis revealed no aseptic loosening or radiolucent line, and showed stable bony fixation at the true acetabulum. The mean thickness of the medial acetabular wall postoperative was 20.5 mm(10 to 36 mm). Bone union of the medial wall was observed at a mean of four months postoperatively. CONCLUSION: Acetabular medial wall osteotomy can maintain the integrity of the acetabular medial wall while achieving enhanced acetabular coverage and more normal hip biomechanics.
Acetabulum ; Arthroplasty ; Biomechanics ; Bone Transplantation ; Displacement (Psychology) ; Follow-Up Studies ; Hip ; Hip Dislocation, Congenital ; Humans ; Osteoarthritis, Hip ; Osteotomy

A 65-year-old woman complained of a pedunculated, huge mass on the anterior chest associated with neurofibromatosis type 1. The clinical and histological data showed the possibility of a malignant peripheral nerve sheath tumor. On electron microscopy, we found the characteristic findings of a malignant peripheral nerve sheath tumor, such as the foci of en-tangled cytoplasmic processes, undifferentiated spindle cells having large pleomorphic nuclei with prominent nucleoli, distinct basal cell lamina, rudimentary cell junctions, intermediate filaments and clumps of glycogen in the tumor cells. We, herein, report a case of malignant peripheral nerve sheath tumor arising from neurofibromatosis, studied by electron microscopy.
Aged ; Cytoplasm ; Female ; Glycogen ; Humans ; Intercellular Junctions ; Intermediate Filaments ; Microscopy, Electron ; Neurofibromatoses* ; Neurofibromatosis 1 ; Peripheral Nerves* ; Thorax

PURPOSE: The aim of this study was to describe the surgical clip-related complications that can occur after open retropubic prostatectomy (RRP), pure laparoscopic prostatectomy (LRP), and robot-assisted laparoscopic radical prostatectomy (RALP). MATERIALS AND METHODS: A database of 641 patients who underwent RRP (n=439), LRP (n=49), and RALP (n=153) at our institution between January 2006 and April 2009 was reviewed to identify patients with complications related to the use of surgical clips. The median follow-up time for the entire cohort was 19.0 months (range, 1-42 months). RESULTS: Of the 641 patients, 25 (5.7%), 1 (2.0%), and 2 (1.3%) had a bladder neck contracture after RRP, LRP, and RALP, respectively. Two RRP patients had a bladder stone. In total, 6 patients had surgical clip-related complications. Metal clip migration was associated with 2 (8%) of the 25 RRP cases of bladder neck contracture and both (100%) of the RRP cases of bladder stone. Moreover, both (100%) of the RALP cases of bladder neck contractures were associated with Hem-o-lok clip migration into the anastomotic site. CONCLUSIONS: Surgical clips are prone to migration and may cause, or significantly contribute to, bladder neck contracture or the formation of bladder stones after radical prostatectomy. These findings also suggest that because the incidence of bladder neck contracture after RALP is low, the migration of Hem-o-lok clips should be suspected when voiding difficulty occurs after RALP.
Cohort Studies ; Contracture ; Follow-Up Studies ; Humans ; Incidence ; Neck ; Prostatectomy ; Prostatic Neoplasms ; Surgical Instruments ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Bladder Neck Obstruction

PURPOSE: The purpose of this study was to compare the patterns of clinical practice in procedural sedation and analgesia (PSA) during lumbar puncture (LP) between the emergency medicine residents (ER) and the pediatric residents (PR), and to evaluate factors that impeded decisions to use sedation and analgesia during LP. METHODS: The survey was sent to ER and PR in a tertiary referral hospital. The survey inquired about clinical practice patterns, experience of PSA training, current administration of PSA during LP and factors that influence PSA use. RESULTS: Sixteen ER and nineteen PR completed the survey. PR were more confident in LP skill than ER. ER used topical analgesic cream and injectable lidocaine more frequently than PR. The most influential factor in PR administering systemic sedative was the concern of respiratory compromise. PR reported less training opportunities during residency than ER. CONCLUSION: Both ER and PR under-administered sedation and analgesia for LP in pediatric patients. ER were administering more injectable lidocaine and topical analgesic cream for LP in children compared to PR. In spite of the increased ER training opportunities, there are rooms for improvement in the practice of sedation and analgesia.
Analgesia ; Analgesics ; Child ; Emergencies ; Emergency Medicine ; Humans ; Internship and Residency ; Lidocaine ; Physician's Practice Patterns ; Spinal Puncture ; Tertiary Care Centers

BACKGROUND: We studied the hemodynamic changes induced by pneumoperitoneum and a reversed Trendelenburg in elderly patients with increased cardiac risk (ASA class III; n = 30; age 70.8 +/- 4.9 years, mean +/- SD) and compared the results with elderly patients at normal risk (ASA class II; n = 30; age 69.2 +/- 4.1 years) during laparoscopic cholecystectomy. METHODS: The transesophageal Doppler monitor was performed after induction of general anesthesia (pre-incision), after onset of pneumoperitoneum (insufflation), after head-up (20degrees) and a left lateral tilt (15degrees) (reversed Trendelenburg) and after deflation and horizontal position (desufflation). Mean arterial pressure (MAP), heart rate, cardiac index (CI) and systemic vascular resistance (SVR) were measured, respectively. RESULTS: Induction of pneumoperitoneum and head-up tilt in patients with cardiac risk resulted significantly in a decrease in CI and an increase in SVR compared with patients with normal risk (P < 0.05), and that remained until deflation, but no interval changes in MAP and heart rate. The CI, MAP and heart rate decreased and SVR increased significantly in patients with cardiac risk compared with patients with normal risk before incision (P < 0.05). No complications occurred. The results indicate that pneumoperitoneum and a reversed Trendelenburg are associated with significant but relatively benign hemodynamic changes. CONCLUSIONS: Anesthesia for laparoscopic cholecystectomy in elderly patients with increased cardiac risk should be performed with an adequate hemodynamic monitoring.
Aged ; Anesthesia ; Anesthesia, General ; Arterial Pressure ; Cholecystectomy, Laparoscopic ; Heart Diseases ; Heart Rate ; Hemodynamics ; Humans ; Organothiophosphorus Compounds ; Pneumoperitoneum ; Vascular Resistance

PURPOSE: Transcatheter device closure of patent ductus arteriosus (PDA) is challenging in early infancy. We evaluated PDA closure in infants less than 6 months old. METHODS: We performed a retrospective review of infants less than 6 months of age who underwent attempted transcatheter device closure in our institution since 2004. To compare clinical outcomes between age groups, infants aged 6–12 months in the same study period were reviewed. RESULTS: A total of 22 patients underwent transcatheter PDA closure during the study period. Patient mean age was 3.3±1.5 months, and weight was 5.7±1.3 kg. The duct diameter at the narrowest point was 3.0±0.8 mm as measured by angiography. The most common duct type was C in the Krichenko classification. Procedural success was achieved in 19 patients (86.3%). Major complications occurred in 5 patients (22.7%), including device embolization (n=1), acquired aortic coarctation (n=2), access-related vascular injury requiring surgery (n=1), and acute deterioration requiring intubation during the procedure (n=1). Two patients had minor complications (9.1%). Twenty-four infants aged 6–12 months received transcatheter device closure. The procedural success rate was 100%, and there were no major complications. The major complication rate was significantly higher in the group less than 6 months of age (P=0.045). There was a trend toward increased major complication and procedural failure rates in the younger age group (P < 0.01). CONCLUSION: A relatively higher incidence of major complications was observed in infants less than 6 months of age. The decision regarding treatment modality should be individualized.
Angiography ; Aortic Coarctation ; Classification ; Ductus Arteriosus* ; Ductus Arteriosus, Patent ; Heart Defects, Congenital ; Humans ; Incidence ; Infant* ; Intubation ; Retrospective Studies ; Vascular System Injuries

STUDY DESIGN: A Case report. OBJECTIVES: We report 4 cases of transverse fracture of upper sacrum with good clinical results. SUMMARY OF LITERATURE REVIEW: There is no clear guideline for the treatment of transverse fracture of upper sacrum. MATERIALS AND METHODS: Four patients, who visited our institute for transverse fracture of upper sacrum, were reviewed from January 2006 to July 2009. RESULTS: All patients had good clinical results after treatment. CONCLUSIONS: In all cases, patients were managed conservatively without reduction or internal fixation. Only for Roy-Camille type 2 and 3 transverse fracture of the upper sacrum with neurologic deficit, decompression was performed, yielding good clinical results.
Decompression ; Humans ; Neurologic Manifestations ; Sacrum

OBJECTIVE: To evaluate whether the change of heel pad thickness improves the pain after Modified Low-Dye Taping (MLDT) in the patient with heel pad atrophy. METHOD: Thirty-five feet of 20 volunteers with heel pad atrophy were selected for the measurement of heel-pad thickness and compressibility index (CI) of the center of calcaneus bone using ultrasound. The subjects were laid in prone with the knees flexed to 90degrees, and an electronic body weight scale was inserted beneath the anterior surface of their knees to take measurements of both UHPT (unloaded heel pad thickness) and LHPT (6 kg-loaded heel pad thickness), which were repeated 3 times respectively. CI was calculated base on LHPT divided by UHPT. After MLDT, the same method was repeated. visual analogue scale (VAS) score was checked at first visit and followed up at second visit. RESULTS: Prior to MLDT, the average value of UHPT (cm), LHPT (cm) and CI value was 0.92+/-0.11, 0.25+/-0.06 and 0.27+/-0.04 respectively. After MLDT, the average was 1.24+/-0.17 for UHPT (cm) and 0.42+/-0.11, for LHPT (cm) while CI stood at 0.33+/-0.06. VAS before MLDT was 7.35+/-1.27 and after MLDT was 3.50+/-1.36, which presented 54% of decrease than initial. CONCLUSION: It was confirmed that the average values of the heel-pad thickness, CI and VAS of patients with heel pad atrophy were improved for MLDT. Accordingly it is considered that application of MLDT is an efficacious treatment and thus further study is needed to develop foot orthoses for heel pad atrophy using the principle of MLDT.
Atrophy ; Body Weight ; Calcaneus ; Electronics ; Electrons ; Foot ; Foot Orthoses ; Heel ; Humans ; Knee

OBJECTIVE: To determine the nutritional status of children with cerebral palsy (CP) and to compare their anthropometric and functional indices. METHOD: Seventy children with cerebral palsy, were at class I (12), II (17), III (18), IV (9) and V (14) on Gross Motor Function Classification System (GMFCS). They varied by age from 25 to 130 months with a mean of 48 months, and consisted of spastic diplegic cerebral palsy (30), quadriplegia (28), triplegia (3), hemiplegia (4), athetoid (4) and hypotonia (1). Evaluation of weight, height, subcutaneous fat thickness, brachial circumference, Body Mass Index (BMI), level of albumin, lymphocyte and blood ferritn were conducted. To identify the factors affecting nutritional status, dietary status and symptoms of dysphagia were investigated. RESULTS: Low BMI percentile was in 23 children (32.9%) and obese condition in 3 children (4.3%). Low BMI percentile tends to frequently observed in groups III, IV, V of GMFCS. BMI percentile with subcutaneous fat thickness, Gross Motor Function Measure (GMFM) score were significantly related (p<0.05). Seen from the symptom of dysphagia, low BMI percentile was correlated with decreased tongue motion (p<0.05). CONCLUSION: Cerebral palsy children with lower GMFM score, decreased tongue motion were significantly related with low BMI percentile. Subcutaneous fat thickness can be useful tool for evaluation of malnutrition of cerebral palsy children.
Body Mass Index ; Cerebral Palsy ; Child ; Deglutition Disorders ; Hemiplegia ; Humans ; Lymphocytes ; Malnutrition ; Muscle Hypotonia ; Muscle Spasticity ; Nutritional Status ; Quadriplegia ; Subcutaneous Fat ; Tongue