The effect of acetabular augmentation with bone graft was reviewed in 12 patients with acetabular deficiency in total hip arthroplasty, performed between 1981 and 1984 at Hanyang University Hospital. Follow-up ranged from 12 to 18 months and averaged 23.3 months. Follow-up radiographs were analyzed. Based on radiography, all grafts were regarded as incorporated and equally successful with autogenous and allograft bone. Long-term follow-up evaluation revealed no evidence of progressive radiolucency or graft resorption. There was one sciatic nerve palsy after operation but recovered at 11 months later.
Acetabulum ; Allografts ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Humans ; Radiography ; Sciatic Neuropathy ; Transplants

Nine surgically proven congenital absence of gallbladder (CAGB) cases were reviewed. All of them had one or more kinds of biliary symptom. Tests such as abdominal ultrasonography, intravenous or oral cholecystography and even endoscopic retrograde cholangiography not only failed to predict CAGB but misleadingly indicated other similar conditions. Only the abdominal computed tomography (CT), performed on one patient, enabled the accurate diagnosis of CAGB. All the patients underwent abdominal exploration, and CAGB was confirmed by the meticulous dissection of the entire extrahepatic biliary tree and the operative cholangiography. Five patients had concomitant biliary pathologies responsible for their symptoms, but four patients had isolated CAGB. CAGB is a rarely encountered condition for a clinician, but extensive diagnostic work-ups including abdominal CT should be performed in all situations where CAGB is suspected. Thus unnecessary exploration can be avoided in the isolated CAGB case.
Bile Duct Diseases/etiology/surgery ; Diagnostic Techniques, Surgical ; Gallbladder/*abnormalities ; Human ; Radiography, Abdominal ; Tomography, X-Ray Computed

Hyperlipidemia is a rare cause of pancreatitis. It has been believed that free fatty acids released from hydrolyzed serum chylomicrons or triglycerides and chylomicrons induce hyperlipidemic pancreatitis by damaging acinar cells and capillaries. Type I, IV or V hyperlipidemic (Fredrickson's classification) pancreatitides have distinctive features of increased and heightened serum chylomicron and triglyceride levels. In contrast, type IIb hyperlipidemia usually doesn't have increased chylomicrons. It is a dominant inherited genetic disorder and doesn't manifest the subjective symptom before combining vascular complications such as coronary artery disease. Only a few cases of type IIb hyperlipidemic pancreatitis have been reported. We experienced a male patient with recurrent hyperlipidemic pancreatitis combined with type IIb hyperlipidemia. We present the case report and a review of the literature of hyperlipidemic pancreatitis, especially cases in Korea.
Tomography, X-Ray Computed ; Recurrence ; Pancreatitis/*etiology/radiography ; Male ; Korea/epidemiology ; Hyperlipoproteinemia Type II/*complications/diagnosis/epidemiology ; Humans ; Adult

Right-sided varicocele is a relatively rare disease, which could be caused by retroperitoneal pathology, situs Inversus or ananomalous termination of the right internal spermatic vein into the right renal vein or the left renal vein. Herein we report a rare case of right-sided varicocele in a 31-year-old fertile man with situs inversus.
Adult ; Humans ; Pathology ; Rare Diseases ; Renal Veins ; Situs Inversus* ; Varicocele* ; Veins

OBJECTIVE: There are few studies of osteoporotic burst fractures with spinal canal compromise that were treated with kyphoplasty. The purpose of this study was to assess the efficacy and the safety of kyphoplasty for the treatment of thoracolumbar spine osteoporotic burst fractures without neurological deficits and to investigate predictors that can improve the effectiveness of this treatment. METHODS: From October 2004 until December 2010, 79 osteoporotic burst fracture patients with asymptomatic spinal canal compromise were treated by kyphoplasty. Kyphoplasty involved injecting polymethylmethacrylate (PMMA) from the anterior one-third of the vertebral body into the posterior one-third of the vertebral body. PMMA powder and liquid were mixed in a ratio of 1:3 at 21-23degrees C. Preoperative and postoperative visual analog scores (VAS), kyphotic angles, the heights of the vertebral body, and the degrees of spinal canal compromise were analyzed. The relationships between the factors and the VAS difference between the preoperative and postoperative states were analyzed. RESULTS: The mean postoperative VAS, the postoperative kyphotic angle, the vertebral body height measurement from the anterior and the middle of the body were significantly improved after kyphoplasty (p<0.05). Postoperatively, the mean VAS was restored from 7.35 to 2.11, the postoperative kyphotic angle was restored from 18.21degrees to 12.08degrees, the vertebral body height measurement from the anterior of the body was from 18.56mm to 23.54mm and the middle of the body was from 24.81mm to 27.90mm. Among the variables, only the duration of symptoms before surgical treatment was implicated as a factor in the outcome (p<0.01). CONCLUSION: Kyphoplasty is a very effective and safe therapeutic modality for the treatment of osteoporotic burst fractures without neurological deficits. The standardization of this procedure helps to avoid complications. In the acute stages, early treatment is more effective for the reduction of pain. Further investigation is warranted in order to assess the effectiveness of early surgery in improving outcome.
Body Height ; Humans ; Kyphoplasty ; Osteoporotic Fractures ; Polymethyl Methacrylate ; Spinal Canal ; Spine

Inonotus obliquus is a fungus that causes white heart rot on several broad-leaved species. This fungus forms typical charcoal-black, sterile conks (chaga) or cinder conks on infected stems of the birche (Betula spp). The dark brown pulp of the sterile conk is formed by a pure mycelial mass of fungus. Chaga are a folk remedy in Russia, reflecting the circumboreal distribution of I. obliquus in boreal forest ecosystems on Betula spp. and in meridional mountain forests on beech (Fagus spp.) in Russia, Scandinavia, Central Europe, and Eastern Europe. Distribution at lower latitudes in Western and Southern Europe, Northern America, Asia, Japan, and Korea is rare. Infected trees grow for many years without several symptoms of decline. The infection can penetrate through stem injuries with exterior sterile conks developing later. In the Czech Republic, cinder conk is found on birches inhabiting peat bogs and in mountain areas with a colder and more humid climate, although it is widespread in other broad leaved species over the Czech Republic. The most common hosts are B. pendula, B. pubescens, B. carpatica, and F. sylvatica. Less frequent hosts include Acer campestre, Acer pseudoplatanus, Alnus glutinosa, Alnus incana, Fraxinus excelsior, Quercus cerris, Q. petraea, Q. robur, Q. delachampii, and Ulmus sp.
Acer ; Alnus ; Asia ; Betula ; Climate ; Czech Republic ; Ecology ; Ecosystem ; Europe ; Europe, Eastern ; European Continental Ancestry Group ; Fagus ; Fraxinus ; Fungi ; Heart ; Humans ; Japan ; Korea ; Medicine, Traditional ; North America ; Quercus ; Russia ; Scandinavia ; Soil ; Trees ; Ulmus ; Wetlands

To investigate morphologic alterations in the rat uterine epithelium after chronic potassium depletion, light and electron microscopic studies were made in rats fed a potassium-free diet for 2 weeks. The uterine epithelium was simple columnar and the uterine gland was simple cuboid cells in toluidine blue staining. In experimental uterus, the epithelial cells contain many brownish granules in the supranuclear and basal cytoplasm. The cells containing dense body with pale halo appeared occasionally among the epithelial cells. By TUNEL staining, more positive cells were observed in experimental uterus than those in control group. By electron microscopy, uterine epithelial cells of control rat had short, irregular microvilli and a few apical vesicles and cytoplasm. Increased microvilli, apical vesicles and fat droplets were observed in uterine epithelial cells of the experimental rat. Apoptotic cells or cells containing apoptotic bodies were sometimes present among the epithelial cells. These results indicate that morphological alterations in the rat uterine epithelium are occurred at chronic potassium depletion, and suggest that hypokalemia may induce apoptosis of uterine epithelium.
Animals ; Apoptosis ; Cytoplasm ; Diet ; Epithelial Cells ; Epithelium* ; Hypokalemia* ; In Situ Nick-End Labeling ; Microscopy, Electron ; Microvilli ; Potassium ; Rats* ; Tolonium Chloride ; Uterus*

The loss of the uterine epithelium surrounding blastocyst is important in bringing the trophoblast into close association with the endometrial stroma during embryonal implantation in several laboratory rodents. It is usually assumed that the epithelial cells die during this process, but the cause of epithelial cell death remains speculative. This study was performed to investigate the mechanism of epithelial cell death during implantation in the endometrium of rat uterus throughout days 5-9 of pregnancy by light and electron microscopy. Cathepsin-D reactivity, detected by imunohistochemistry, was localized to all viable epithelia, some degenerating epithelial and decidual cells between days 5-9 of pregnancy. DNA fragmentation, detected by TUNEL staining, was observed in degenerating epithelial and decidual cells throughout days 6-9 of pregnancy. Cellular fragments within lumen and phagosome within trophoblasts were reacted positively to TUNEL staining. Electron microscopy revealed that the epithelium lining the antimesometrial chamber was sloughed off into the lumen on day 6 of pregnancy. Its cell organelles appeared healthy but its nucleus was condensed and irregular shaped. The detached epithelial cells lining the antimesometrial chamber on day 7 of pregnancy contained condensed and fragmented nuclei, but exhibited different morphological pattern according to the intactness or loss of cytoplamic organelles and membrane. And these cells were surrounded and phagocytosed by trophoblasts. On day 7 of pregnancy, syncytial knots were formed, and later these knots and most of detached epithelial cells were severely degenerated. Some decidual cells nearby the lumen were also degenerated at this period. These results indicate that the epithelial cell death of rat uterine endometrium during implantation is mainly due to the process of apoptosis and these dying cells are removed by trophoblasts.
Animals ; Apoptosis ; Blastocyst ; DNA Fragmentation ; Endometrium ; Epithelial Cells* ; Epithelium ; Female ; In Situ Nick-End Labeling ; Membranes ; Microscopy, Electron ; Organelles ; Phagosomes ; Pregnancy ; Rats* ; Rodentia ; Trophoblasts ; Uterus*

Methotrexate (MTX), folic acid antagonist, is effective against the cancer, but is often accompanied by damage to the small intestine due to its inhibition of cell division. The nature of cell damage induced by MTX on the surface lining and crypt cells of the small intestine was investigated in the rat receiving MTX administration. MTX was injected once in every other day intraperitoneally to rats [0.03, 0.1, and 0.3 mg per 100 g body weight in small (SD), large (LD), and over dose (OD) groups, respectively] and the animals were sacrificed with various intervals after single, three-, five-times administrations of SD, single, three-, four-times administrations of LD, and single administration of OD. In case of three times injection of LD, intravenous injection was also made. Three portions, duodenum, jejunum, and ileum of the small intestine were studied by light and electron microscopy. Histologically, there were no appreciable morphological changes in villi and crypts after single and three times administrations of SD. The cells contained dense nucleus with clear cytoplasm, however, were rarely presented among the crypt cells. The duodenal villi were relatively normal in shape, but the number of crypts were somewhat decreased in five times administrations of SD. On the other hand, the villi of jejunum and ileum were atrophied and the epithelial cells became flattened. Crypts were atrophied and decreased in number. In single administration of LD, the shape of villi were normal in all of three portions. The cellular damages were noted in crypts of all of them, and the severity was most predominant at 6 hours than at 2, 4, or 24 hours after administration. In three times administrations of LD, more serious damages were noted in intravenous injection groups than intraperitoneal injection groups. Villi and crypt of the jejunum and ileum became atrophy, and epithelial cells were vacuolated. In four times administrations of LD, loss of villi and atrophied glands contained cellular debris within their lumen were noted in all three portions. In single administration of OD, there was no remarkable changes in histological structures of duodenum, jejunun, and ileum. With TUNEL staining, positive cells were present mainly in the crypt. The positive cells appeared among the glandular cells and were consistent with dense nucleus contained cells in hematoxylin-eosin stain. In small dose group the number of apoptotic cells in duodenum and ileum was increased in proportion to the times of administration, but that in jejunum was decreased after three times of administrations because of the destruction of crypts. Most prominent apoptotic changes of crypt cells were noted at 6 hours compare with 2, 4, and 24 hours after three times administrations of SD. Positive cells appeared most numerous at 6 hours after single administration of LD and OD. Destructive changes of crypt were found in jejunum and ileum after three times intravenous injection of LD, and were found in all portions after four times administrations of LD. Electron microscopic observation generally confirmed the findings of light microscopy. The apoptotic cells appeared in the crypt and was characterized by chromatin condensation and fragmentation, cytoplasmic condensation. Notable changes were observed in epithelial and crypt cells after five- and four-times administrations of SD and LD, respectively. The epithelial cells became flat and had many fat droplets in the cytoplasm. The crypts were atrophied and the glandular cells were very flat. These changes were more severe in jejunum and ileum than in duodenum. These results indicate that the damage of small intestine by MTX is more severe in jejunum and ileum than in duodenum, and also suggest that the cell death of the crypt is mediated by apoptosis, and that of the epithelial cell is due to fatty degeneration.
Animals ; Apoptosis ; Atrophy ; Body Weight ; Cell Death* ; Cell Division ; Chromatin ; Cytoplasm ; Duodenum ; Epithelial Cells ; Folic Acid ; Hand ; Ileum ; In Situ Nick-End Labeling ; Injections, Intraperitoneal ; Injections, Intravenous ; Intestine, Small* ; Jejunum ; Methotrexate* ; Microscopy ; Microscopy, Electron ; Rats*

Inspissated bile syndrome (IBS) is a relatively rare condition. Many treatment options are available, including medication, surgery, and surgical interventions, such as insertion of cholecystostomy drain, endoscopic retrograde cholangiopancreatography, internal biliary drainage, and percutaneous transhepatic biliary drainage (PTBD). We herein report the first case of IBS that was successfully treated with PTBD in a two-month-old infant in Korea. PTBD was initiated on postnatal day 72. On postnatal day 105, we confirmed complete improvement and successfully removed the catheters. This report suggests that PTBD is a viable and safe treatment option for obstructive jaundice in very young infants.
Bile* ; Catheters ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystostomy ; Drainage* ; Humans ; Infant* ; Jaundice, Obstructive ; Korea