BACKGROUND: Neer type II distal clavicle fractures have the drawback of coracoclavicular instability and insufficient distal bony fragment, thereby making it difficult to achieve adequate fixation. Although various surgical treatments have been described for Neer type II fracture, the optimal treatment remains controversial. This study reports the clinical results and usefulness of anatomical locking plate with additional K-wire fixation. METHODS: A totally of 21 patients with type II distal clavicle fracture were included in the study. The surgical procedure reduced the fracture temporarily; it included insertion of one or two K-wire from the lateral margin of the distal fragment to the proximal fragment through the fracture site, followed by application and fixation of the locking plate. The bony union and migration of K-wire was evaluated in the follow-up radiography. The coracoclavicular distance and acromioclavicular joint arthrosis were assessed at the final follow-up. The Constant Score (CS) and Korean Shoulder Score (KSS) were evaluated for clinical scoring. RESULTS: Bone union was achieved in all cases. At the final follow-up, coracoclavicular distance of the injured shoulder was increased, as compared to the intact shoulder (p=0.002), with no accompanying clinical symptoms. No K-wire migration was observed. At the final follow-up, K-wire irritation was observed in two cases and acromioclavicular arthrosis in one case, with no other adverse effects. Pain visual analogue scale, CS, and KSS were improved in all cases. CONCLUSIONS: The method of anatomical locking plate with additional K-wire fixation could be useful in achieving beneficial clinical results.
Acromioclavicular Joint ; Clavicle* ; Follow-Up Studies ; Humans ; Methods ; Radiography ; Shoulder

The analysis of 48 infants of congenital torticollis and the result of their conservative treatment are reported. The abnormalities of their neck were noticed by mothers within three months of infant life but mostly at three to four weeks. The ratio of male to female was 9:7 and incidence of right and left was 30 to 18. The mass located mostly(50%) at middle third of the sternocleidomastoid muscle belly. The prominence of incidence were noticed on the abnormality of fetal position in the uterus, mode of delivery and also on the baby of elderly primipara. About 67% of cases were breech(46%) and transverse(21%) position prenatally and 67% were delivered by forceps(41.7%), vacum and induction(12.5%each). The age of mother at delivery has close relationship between congenital torticollis with about two third of them are born of 29–34 year old mother and primipara infants were 61%. For the treatment, daily stretch exercises of affected sternocleidomastoid muscle was done by physical therapist for 20–30 times in two separate session. The effect can be noticed by the gradual correction of rotation deformity first and then the mass become soften and smaller. The next change is the correction of deviation deformity but the mass remain last. However, the mass remaining one fourth of original size was absorbed spontaneously without further treatment. The result of complete cure in ten weeks of treatment were 43(90%) out of 48 patients and the remianing five cases required for 15 weeks of treatment. In conclusion the congenital torticollis can be treated effectively by stretch exercises when it began within three months of age of the patient. A hundred per cent effect of cure may be obtained in ten weeks of treatment in case of initial treatment is begin within four weeks of age and required for 15 weeks of treatment on 4–12 weeks old infants.
Aged ; Congenital Abnormalities ; Exercise ; Female ; Humans ; Incidence ; Infant ; Male ; Mothers ; Neck ; Physical Therapists ; Torticollis ; Uterus

PURPOSE: This study was conducted to compare the PET and CT findings for patients with a pulmonary lymphangitic metastasis. MATERIALS AND METHODS: We retrospectively reviewed the PET and CT findings of seven patients diagnosed with a pulmonary lymphangitic metastasis between May 2005 and May 2007. RESULTS: All patients had interstitial thickening, as seen on a CT scan, while the PET scans showed abnormal findings in only three patients. In these three patients, one patient had interlobular septal thickening of more than 10, another patient had interlobular septal thickening of more than 5 but less than 10, and another patient had interlobular septal thickening of less than 5. All of the patients had bronchovascular bundle thickening. However, among the four patients that had normal FDG uptake, no patient had interlobular septal thickening of more than 10, two of the patients had interlobular septal thickening of more than 5 but less than 10, and the remaining patients had interlobular septal thickening of less than 5. Only two of the patients had bronchovascular bundle thickening. CONCLUSION: All patients with pulmonary lymphangitic metastasis have typical CT findings, but some of the patients had FDG uptake, as seen in the PET scans. Thus, CT is a more useful modality for diagnosis for pulmonary lymphangitic metastases.
Diagnosis ; Humans ; Lung Neoplasms ; Lymphatic Metastasis ; Neoplasm Metastasis* ; Positron-Emission Tomography ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To assess the high-resolution CT and pathologic findings of fat embolism experimentally induced in rabbit lung. MATERIALS AND METHODS: Twelve rabbits were divided into four groups, namely control, 2-hour, 24-hour, and 72-hour, with three rabbits in each, and closed tibiofibular fractures were induced. After the rabbits were sacrificed, high-resolution CT scanning of the artificially inflated lungs was performed, and the CT findings were analyzed by two radiologists. They determined the presence or absence of ground glass opacity or consolidation, the extent of the lesions (using a 10% grading scale), and their distribution, reaching a consensus. The pathologic findings were analyzed using the specimens prepared by H & E and Oil-red O staining. RESULTS: Although the high-resolution CT findings of pulmonary fat embolism were nonspecific, bilateral patchy ground glass opacity (100%), and focal air-space consolidation surrounding the bronchovascular bundle (89%) were most common. In all groups, the occlusion of vessels by fat globules was confirmed by Oil-red Ostaining. The microscopic findings included focal pulmonary hemorrhage, edema, alveolar collapse, and extensive infiltration of inflammatory cells in the lung parenchyma. The 24-hour group showed more extensive change in high-resolution CT and pathologic findings than did the others. CONCLUSION: Fat embolism in rabbit lung may occur after closed tibio-fibular fracture. The extent of the lesion revealed by high-resolution CT correlated closely with the pathologic findings. High-resolution CT may thus be helpful for the detection of pulmonary fat embolism and evaluation of its extent.
Consensus ; Edema ; Embolism, Fat* ; Glass ; Hemorrhage ; Lung* ; Pulmonary Embolism ; Rabbits ; Tomography, X-Ray Computed

PURPOSE: To determine whether the compression technique is a valuable additional method for differentiating between benign and malignant breast masses. MATERIALS AND METHODS: The ultrasonographic findings of 95 benign and 53 malignant masses, all pathologically proven, were prospectively analyzed with regard to five diagnostic criteria: shape (regular/irregular), retrotumoral acoustic phenomena (posterior enhancement/posterior attenuation), internal echo pattern (homogeneous/inhomogeneous), compression effect on shape (distortion/no change), and compression effect on internal echo pattern (more homogeneous/no change). RESULTS: The number of cases of benign and malignant masses, respectively, was as follows: regular / irregular shape: 84/11, 9/44; posterior acoustic enhancement/posterior attenuation: 82/13, 16/37; homogeneous/inhomogeneous internal echo pattern: 78/17, 14/39; distortion/no change in shpae: 76/19, 5/48; and more homogeneous/ no change in internal echo pattern: 71/24, 3/50. For all diagnostic criteria for the differentiation of benign and malignant masses, the differences were statistically significant (p<.05). CONCLUSION: Ultrasonography is helpful for differentiating between benign and malignant breast masses. The compression technique is a valuable additional diagnostic method.
Acoustics ; Breast* ; Prospective Studies ; Ultrasonography*

Toxoplasma gondii, an intracellular coccidian protozoan, is the causative agent of toxoplasmosis, a widespread infection affecting various birds and mammals including humans. In immunocompetent hosts, the infection is usually asymptomatic and benign. Toxoplasmosis is either congenital or acquired. In general prenatal therapy of congenital toxoplasmosis is beneficial in reducing the ncy of infant infection. Therapies are based primarily on spiramycin because of the relative lack of toxicity and high concentration achieved in the placenta. Clindamycin is the standard drug for chemoprophylaxis in newborn infants, and is directed at preventing the occurrence of retinochoroiditis as a late sequel to congenital infection. The standard treatment for acquired toxoplasmosis in both immunocompetent and immunodeficient patients is the synergistic combination of pyrimethamine and sulphonamides. Toxoplasmic encephalitis is tbe most common manifestation of acquired toxoplasmosis in immunocompromised patients and if not treated is fatal. However, because of toxicity, the therapeutic efficacy of pyrimethamine sulphonamide combinations may be seriously limited in immunodeficient patients. We have experienced a case of toxoplasmosis during the workup of habitual aborter. So we report this case with a brief review of literatures.
Birds ; Chemoprevention ; Clindamycin ; Encephalitis ; Humans ; Immunocompromised Host ; Infant ; Infant, Newborn ; Mammals ; Placenta ; Pyrimethamine ; Spiramycin ; Toxoplasma ; Toxoplasmosis* ; Toxoplasmosis, Congenital

Systemic lupus erythematosus(SLE) is a multisystem disorder with a peak age of onset in the second and fourth decades of life predominantly occuring in females who will usually have the potential to become pregnant. This female to male predominance is greatest during childbearing years approaching a ratio of 13:1, after the menopause it declines to a ratio of 3:1, the ratio also seen in prepubertal years. In practice, despite the higher prevalence of rheumatiod arthritis, pregnancy in SLE is the most common management problem confronting physician and obstetrician amongst the connective tissue disorders and it is particularly important as the outcome of pregnancy is more unpredictable in this disease. As well as having clinical consequences for the health of both mother and fetus, pregnancy in lupus provides a model for studying the importance of other biological phenomena characterizing the disease. For example, the transplacental passage of maternal antibodies to Ro(SSA) and La(SSB) and their strong association with the neonatal lupus syndrome suggests a pathogenetic role for these autoantibodies. Other relevant issues are feto-meternal immunological tolerance and hormonal interaction with the immune system. We have experienced a case of recurrent pregnancy loss associated with systemic lupus erythematosus. So we report this case with a brief review of literatures.
Age of Onset ; Antibodies ; Arthritis ; Autoantibodies ; Biological Phenomena ; Connective Tissue ; Female ; Fetus ; Humans ; Immune System ; Lupus Erythematosus, Systemic* ; Male ; Menopause ; Mothers ; Pregnancy* ; Prevalence

The purposes of this study were to investigate the effects of drug use & the health-related habits(alcohol drinking, smoking and exercise) on the nutritional status of elderly. subjects were 362 free-living elderly aged over 65(male 131, female 231) in Chungbuk area. Interviews with questionaire on drug use, health-related habits, and nutrient intakes, anthropometric measurement and biochemical blood test were carried out from August to October in 1996. Energy intakes of the males who used drug were lower than those of males who did not use any drug, while energy intakes of the females who used drug were higher than those of females who did not. In biochemical indices, LDL-cholesterol level of the males who used drug was higher than that of males who did not have drug. serum triglycerides, VLDL-cholesterol and obesity degree(BMI & TS) of the females who used drug were higher than those of females who did not have drug. Alcohol drinking, smoking and exercise habits of the elderly who used drug had little effects on the nutrient intakes while those habits had considerable effects on biochemical indices and obesity degree. Among drug users, male drinkers showed higher triglycerides & HDL-cholesterol level, and female drinkers showed higher triglycerides and lower total cholesterol and LDL-cholesterol level, compared to non drinkers. Among female drug users, smokers showed lower body mass index(BMI) compared to non smokers. Males and females who had both drinking and smoking habits showed higher serum triglycerides and VLDL-cholesterol level. Especially females who had both drinking and smoking habits showed lower BMI & Tricep skinfold thickness compared to those who had netiher drinking nor smoking habits.
Aged* ; Alcohol Drinking ; Cholesterol ; Chungcheongbuk-do* ; Drinking* ; Drug Users ; Female ; Hematologic Tests ; Humans ; Male ; Nutritional Status* ; Obesity ; Skinfold Thickness ; Smoke ; Smoking* ; Tobacco Products* ; Triglycerides

BACKGROUND: There have been few reports suggesting involvement of mast cell and neutrophil to induce bronchoconstriction in aspirin-sensitive asthrna. OBJECTIVE: To evaluate mast cell and neutrophil activation in pathogenesis of aspirin-sensitive asthma. MATERIAL AND METHOD: We observed changes of serum NCA and MPO levels during L-ASA bronchoprovocation test in 14 subjects with aspirin-sensitive asthma. RESULTS: Serum NCA was significantly increased at 30 min(p=0.01) after the inhalation of L-ASA and then, no significant changes were noted at 240 min (p=0.14). NCA was significantly higher in subjects with late asthmatic responses than in those without it (p=0.04). Serum MPO level tended to increase at 30 min with no statistical significance (p=0.08), and then it significantly decreased at 240 min (p=0.05). There was no significant correlation between serum NCA and MPO level (r=0.22, p=0.58). CONCLUSION: These results support the view that NCA derived from mast cell may contribute to neutrophil recruitment into the airway in aspirin-sensitive asthmatic patients.
Asthma ; Bronchoconstriction ; Humans ; Inhalation ; Mast Cells ; Neutrophil Activation ; Neutrophil Infiltration ; Neutrophils*

BACKGROUND: Cardiopulmonary bypass during open heart surgery causes systemic inflammatory respose. IL-10 is an anti-inflammatory cytokine that inhibits inflammatory process and protects organ function by down regulation of pro-inflammatory cytokine release and maintenance of blood level balance with pro-inflammatory cytokines. MATERIAL ateial and Method: Plasma IL-10 levels were measured and analyzed in 22 patients who underwent open heart surgery (11 cases of coronary artery bypass graft, 11 cases of valve replacement) under cardiopulmonary bypass since 1988 January to July at Department of Thoracic and Czardiovascular surgery, Yeungnam University Hospital. 1g of methylprednisolone was administrated to thirteen patients randomly. Blood samp.es were taken and collected at the time of induction of anesthesia, 10 min before cardiopulmonary bypass, 10 min after starting of CPB, 10 min aftr aortic cross clamping, 10 min after ACC release, and 10 min, 2 hours, and 5 hours after CPB respectively. The plasma levels of IL-10 were determined by enzyme-linked immunosorbent assays (ELISA). Wilcoxon-Raule Sum test was used for statistical analysis. In all 22 patients, cardiopulmonary bypass time was used for statistical analysis. In all 22 patients, cardiopulmonary bypass time was 171+/-41.4 min and aortic cross clamp time was 118+/-36.5 min. Peak IL-10 level was achieved at 10 min after ACC (361.0+/-52.81pg/ml) and was decreased sharply at 2 hours after CPB. Peak IL-10 level was correlated positively with aortic cross clamp time (p=0.011); however, it did not correlated with bypass time (p=0.181). In valve replacement group, mean IL-10 level at peak point was 567.89+/-107.69 pg/ml and was significantly higher than that of coronary artery bypass group (205.67+/-192.70 pg/ml) (p<0.001). ACC time in valve replacement group was significantly longer than that of coronary artery bypass group (p<0.01), however, bypass time was not (p=0.212). Thirteen patients with steroid pretreatment before starting of CPB showed relatively higher plasma IL-10 level than in control group, however, no statistical significance was noted (p=0.19). CONCLUSION: plasma level of IL-10 was increased in association with cardiopulmonary bypass and revealed peak at 10 min after ACC release. IL-10 level was correlated positively with ACC time. Therefore, systemic inflammatory respeonse in association with cardiopulmonary bypass could be decreased by reducing ACC time during cardiac surgery.
Anesthesia ; Cardiopulmonary Bypass* ; Constriction ; Coronary Artery Bypass ; Cytokines ; Down-Regulation ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-10* ; Methylprednisolone ; Plasma ; Thoracic Surgery ; Transplants