Malignant transformation of fibrous dysplasia to osteosarcoma is rare. We report a case in which monostotic fibrous dysplasia of the proximal femur treated with curettage, Ender nailing and bone grafting was differentiated into the osteosarcoma in a 58-year-old female.
Bone Transplantation ; Curettage ; Female ; Femur ; Fibrous Dysplasia, Monostotic ; Humans ; Middle Aged ; Osteosarcoma

Background: and Purpose: To determine whether the postcessation weight gain modifies the protective effect of smoking on the development of Parkinson’s disease (PD). Methods: This nationwide cohort study included 3,908,687 Korean males aged ≥40 years who underwent at least 2 health checkups biennially between 2009 and 2015. They were grouped into current smokers; quitters with body mass index (BMI) increase, maintenance, and decrease; and never smokers. The occurrence of incident PD was tracked, and Cox proportional-hazard models were used to adjust for potential confounding factors. We also analyzed the impact of weight change regardless of smoking status in the study population. Results: There were 6,871 incident PD cases observed during the 13,059,208 person-years of follow-up. The overall risk of PD was significantly lower in quitters than in never smokers [hazard ratio (HR)=0.78, 95% confidence interval (CI)=0.70–0.86]. The risk of PD was still lower in quitters with BMI increase (HR=0.80, 95% CI=0.65–0.98) and in those with BMI maintenance (HR=0.77, 95% CI=0.68–0.87). This tendency was also observed in quitters with BMI decrease (HR=0.76, 95% CI=0.55–1.06), although it was not as robust as in the other two groups.With respect to weight change alone, BMI increase (HR=1.10, 95% CI=1.02–1.18) but not BMI decrease (HR=1.06, 95% CI=0.98–1.14) significantly increased the PD risk compared to BMI maintenance. Conclusions Postcessation weight gain in males did not offset the protective impact of smoking on PD development, although overall weight gain predicted an increased risk of PD.

No abstract available.
Cell Proliferation* ; Female ; Humans ; Trophoblasts*

No abstract available.
Exostoses ; Fingers ; Korea

PURPOSE: To study clinical results and complications in the treatment of infected nonunion of the tibia according to location of nonunion and reconstruction for soft tissue defect. MATERIALS AND METHODS: 36 cases of tibia infected nonunion which were treated with the llizarov included in this study. There were proximal 1/3 in 14, middle 1/3 in 10, and distal 1/3 in 11 cases. Coverage of the soft tissue were treated with the free flap in 8 cases as classified group A and non-free flap in 17 cases classified group B. We evaluated the healing index, complications and comparing the results of each treatment by the Paley method. RESULTS: Bone union was achieved in all cases. The proximal nonunion showed better results than those in the middle and distal area; average healing index: 35.6 days/cm (p=0.038), bone results: 92.9% (p=0.025), functional result: 90.5% (p=0.03). Group B showed significantly better results as it showed average healing index: 30.3 days/cm (p=0.015), bone results: 85.7% (p=0.025), functional results: 90.5% (p=0.015). CONCLUSION: The nonunion of proximal 1/3 showed better results than other sites. Soft tissue reconstruction with free flap that control infection more effectively, could be improved the treatment outcomes.
Free Tissue Flaps ; Tibia

BACKGROUND AND OBJECTIVES: Mechanical circulatory support with extracorporeal membrane oxygenation (ECMO) and ventricular assist device has always been the optimal choice for treating the majority of medically intractable low cardiac output case. We retrospectively investigated our institution's outcomes and variables associated with a high risk of mortality. SUBJECTS AND METHODS: From 1999 to 2014, 86 patients who were of pediatric age or had grown-up congenital heart disease underwent mechanical circulatory support for medically intractable low cardiac output in our pediatric intensive care unit. Of these, 9 grown-up congenital heart disease patients were over 18 years of age, and the median age of the subject group was 5.82 years (range: 1 day to 41.6 years). A review of all demographic, clinical, and surgical data and survival analysis were performed. RESULTS: A total of 45 (52.3%) patients were successfully weaned from the mechanical assist device, and 25 (29.1%) survivors were able to be discharged. There was no significant difference in results between patients over 18 years and under 18 years of age. Risk factors for mortality were younger age (<30 days), functional single ventricle anatomy, support after cardiac operations, longer support duration, and deteriorated pre-ECMO status (severe metabolic acidosis and increased levels of lactate, creatinine, bilirubin, or liver enzyme). The survival rate has improved since 2010 (from 25% before 2010 to 35% after 2010), when we introduced an upgraded oxygenator, activated heart transplantation, and also began to apply ECMO before the end-stage of cardiac dysfunction, even though we could not reveal significant correlations between survival rate and changed strategies associated with ECMO. CONCLUSION: Mechanical circulatory support has played a critical role and has had a dramatic effect on survival in patients with medically intractable heart failure, particularly in recent years. Meticulous monitoring of acid-base status, laboratory findings, and early and liberal applications are recommended to improve outcomes without critical complication rates, particularly in neonates with single ventricle physiology.
Acidosis ; Bilirubin ; Cardiac Output, Low* ; Creatinine ; Critical Care* ; Extracorporeal Membrane Oxygenation ; Heart Defects, Congenital ; Heart Failure ; Heart Transplantation ; Heart-Assist Devices ; Humans ; Infant, Newborn ; Intensive Care Units* ; Lactic Acid ; Liver ; Mortality ; Oxygen ; Oxygenators ; Physiology ; Resuscitation ; Retrospective Studies ; Risk Factors ; Survival Rate ; Survivors

Swallow or deglutition syncope is a rare cause of syncope. It occurs due to a vagal reflex while swallowing. We present here a patient with recurrent loss of consciousness after swallowing liquid. He had a 1-month history of concurrent chemoradiotherapy due to non-small cell lung cancer. Electrocardiogram monitoring revealed atrioventricular block with swallowing of beverages. The details of this case suggest that chemoradiotherapy to mediastinum may cause neurogenic swallow syncope.
Atrioventricular Block ; Beverages ; Carcinoma, Non-Small-Cell Lung ; Chemoradiotherapy* ; Deglutition ; Electrocardiography ; Humans ; Lung Neoplasms* ; Lung* ; Mediastinum ; Reflex ; Syncope* ; Unconsciousness

OBJECTIVE: To establish the objective method of diagnosing the myofascial pain syndrome through diagnostic ultrasound and pathology. METHOD: Hamstring muscles of 7 female house rabbits, weighing 2.5~3.0 Kg, were studied. The existence of nodule was confirmed by palpation and through diagnostic ultrasound. A horizontal length, vertical length, thickness, and an area of hyperechoic region were measured. Hyperechoic regions were biopsied and stained with hematoxylin-eosin. RESULTS: All examined rabbits had muscular nodules in the medial hamstring. Characteristic increase of echogenecity was observed in the medial hamstring muscles. Some uneven hyperechoic areas were seen in the lateral hamstring muscles. Fatty degeneration and giant round cells were observed in the medial hamstring where the echogenecity was increased. The giant round cells were observed only in the lateral hamstring. CONCLUSION: Increased echogenecity of the medial hamstring muscle is probably contributed by muscles cells with fatty degeneration and giant round cells, and some portions of hyperechogenecity of lateral hamstring requires further study.
Female ; Humans ; Muscles ; Myofascial Pain Syndromes* ; Palpation ; Pathology ; Rabbits ; Ultrasonography*

BACKGROUND: The evidence for H. pylori as a gastrointestnal pathogen is now very strong, if not overwhelming. Among the pathogenic factors of H. pylori, flagella and urease are considered to be major factors causing the gastrododenal disease. We observed the gene diversity of H. pylori using the PCR-amplified 1.4Kb fla A gene and 0.9Kb ure B gene and examined the relationship between the gene pattern and the gastroduodenal disease. METHOD: Fifty-one cases of isolated strains were cultured at the Helicobacter-selective blood agar plates. To compare the gene diversity among the isolates of gastroduodenal disease genotypes was analyzed by PCR-based RFLP. 1.4Kb fla A gene and 0.9Kb ure B genes from isolates were amplified by PCR and digested with Hae 3 restriction enzymes to observe the restriction fragment length polymophysm. Protein patterns were also compared to examine the antigenic variations. Total cell proteins, and octyl-glucose extracts from isolates were analyzed by SDS-PAGE gel electrophoresis. RESULTS: 41 cases (80.4%) of H. pylori were isolated in the 51 cases of gastroduodenal diseases. We could classify theses isolates 3 types of PCR-RFLP in the fla A gene, 900+500bp, 500+500+400bp, 600+800bp, and 9 types in the ure B gene. PCR-RFLP in the fla A gene and ure B gene of the isolates was different from the standard strain of Australia and the genetic diversity was not related to the types of the gastroduodenal disease. We demonstrated variations in the protein pattern and antigenic profiles among the isolates by SDS-PAGE analysis. These data also did not show any relationship between protein pattern and types of gastroduodenal diseases. CONCLUSION: Tese studies showed many different gene diversity in the flagella and urease gene without any relationship with the types of gastoduodenal disease. And variable protein pattern were noted among the strains of H. pylori. Further studies to demonstrate the pathgenecity of H. pylori should be continued even if there was no relationship between the genomic diversity of the flagella or urease and the types of gastroduodenal disease.
Agar ; Australia ; DNA* ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Flagella ; Genes, vif ; Genetic Variation ; Genotype ; Helicobacter pylori* ; Helicobacter* ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Urease