Purpose: This study assessed the results of surgical treatment for Neer type-II and type-V unstable distal clavicle fractures via hybrid fixation with a locking compression plate and finger trap wire. Materials and Methods: From September 2016 to April 2018, 15 patients treated for Neer type-II and type-V unstable distal clavicle fractures using hybrid fixation were analyzed retrospectively. The clinical results were analyzed based on the radiological healing time, range of motion of the shoulder joint, American Shoulder and Elbow Society (ASES) score, and the University of California at Los Angeles (UCLA) shoulder score. Results: The range of motion of the shoulder joint completely recovered to the normal range within 9.2 weeks on average (6−24 weeks). Furthermore, the follow-up of the clinical trial showed excellent results, including an ASES score of 98.5±2.3 and an UCLA score of 34.2±1.3. In addition, fracture union was successfully achieved in all cases, and was identified during week 15 on average. Conclusion For the treatment of unstable distal clavicle fractures, hybrid fixation is a useful surgical method with excellent clinical outcomes through rapid recovery of the range of motion of the shoulder joint after surgery.

A testis tumor is comparatively rare and most of them are discovered as a palpable asymptomatic mass. We recently experienced two cases of incidental testicular tumor during scrotal exploration for trauma. Pathologic study revealed a mixed germ cell tumor and mature teratoma, so we report here on these two cases with a review of the related literatures.
Neoplasms, Germ Cell and Embryonal ; Teratoma ; Testicular Neoplasms ; Testis

A testis tumor is comparatively rare and most of them are discovered as a palpable asymptomatic mass. We recently experienced two cases of incidental testicular tumor during scrotal exploration for trauma. Pathologic study revealed a mixed germ cell tumor and mature teratoma, so we report here on these two cases with a review of the related literatures.
Neoplasms, Germ Cell and Embryonal ; Teratoma ; Testicular Neoplasms ; Testis

We present three neuropathologically-verified and two clinically-probable cases of Creutfeldt Jakob disease. All five had nonspecific prodromal complaints or symptoms prior to overt neurological signs and showed striking progressive neurologic deterioration, especially cognitive decline and cerebellar dysfunction. Myoclonic involuntary movements and complete decapitated states followed in one or two months. The characteristic even pathognomonic in proper clinical settings, features of electroencephalography, magnetic resonance imaging and positron emission tomography and pathologic findings are presented.
Cerebellar Diseases ; Creutzfeldt-Jakob Syndrome* ; Dyskinesias ; Electroencephalography ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Strikes, Employee

The aim of this study was to identify a new gene of Haemophilus parasuis that could be used to develop a polymerase chain reaction (PCR) test for this porcine pathogen. H. parasuis genomic DNA was cloned into a set of expression vectors, and transformants expressing His-tagged polypeptides were identified by colony blotting. An ABC transporter-like gene was isolated. The cloned DNA fragment is 1,105 base pair and shows 78% similarity at the nucleotide level with an ABC transporter gene of H. ducreyi. Based on this sequence, two PCR primers were designed to amplify the entire 1,105-bp fragment in the proposed diagnostic PCR test. PCR amplification was able to detect a minimum of 1 x 10(4) CFU/ml of H. parasuis organisms. Fifteen different H. parasuis serovars were positive using the PCR test. No amplification was observed when the test was done using DNA from 16 other bacterial species commonly isolated from swine.
Base Pairing ; Clone Cells ; Cloning, Organism ; DNA ; Haemophilus ; Haemophilus parasuis ; Peptides ; Polymerase Chain Reaction ; Swine

It is known that most of the extrahepatic metastasis of hepatocellular carcinoma occurs through the blood stream and the most frequent target organ is the lung. Intraperitoneal metastasis via the lymphatics is rare (2~16%) and this has been largely demonstrated by laparosopy or on the autopsy findings. Especially, omental metastasis of hepatocellular carcinoma has only been rarely reported on. A 62-year-old male patient who underwent TACE for hepatocellular carcinoma was admitted for an emergency operation for hemoperitoneum. On the operative findings, there were two 1.5 by 3 cm-sized masses in the omentum and one of them was ruptured and bleeding. The masses were diagnosed as metastatic hepatocellular carcinoma on the pathologic examination. The patient recovered and is being followed.
Autopsy ; Carcinoma, Hepatocellular* ; Emergencies ; Hemoperitoneum* ; Hemorrhage ; Humans ; Lung ; Male ; Middle Aged ; Neoplasm Metastasis ; Omentum ; Rivers ; Rupture, Spontaneous*

BACKGROUND/AIMS: Currently, there is no consensus on the necessity of repeated radioiodine therapy (RAI) in patients who show iodine uptake in the thyroid bed on a diagnostic whole-body scan (DxWBS) despite undetectable thyroglobulin (Tg) levels after remnant ablation. The present study investigated the clinical outcomes of scan-positive, Tg-negative patients (WBS+Tg-) who did or did not receive additional RAI. METHODS: We retrospectively reviewed 389 differentiated thyroid carcinoma patients who underwent a total thyroidectomy and received high-dose RAI from January 2003 through December 2005. The patients were classified according to surveillance DxWBS findings and TSH-stimulated Tg levels 6 to 12 months after the initial RAI. RESULTS: Forty-four of the 389 patients (11.3%) showed thyroid bed uptake on a DxWBS despite negative Tg levels (WBS+Tg-). There was no difference in clinical and pathological parameters between WBS+Tg- and WBS-Tg- patients, except for an increased frequency of thyroiditis in the WBS+Tg- group. Among the 44 WBS+Tg- patients, 27 subjects were treated with additional RAI; 25 subjects showed no uptake in subsequent DxWBS. Two patients were evaluated only by ultrasonography (US) and displayed no persistent/recurrent disease. The other 17 patients received no further RAI; Eight patients and two patients showed no uptake and persistent uptake, respectively, on subsequent DxWBS. Six patients presented negative subsequent US findings, and one was lost to follow-up. Over the course of 53.2 +/- 10.1 months, recurrence/persistence was suspicious in two patients in the treatment group. CONCLUSIONS: There were no remarkable differences in clinical outcomes between observation and treatment groups of WBS+Tg- patients. Observation without repeated RAI may be an alternative management option for WBS+Tg- patients.
Adult ; Aged ; Female ; Humans ; Iodine Radioisotopes/pharmacokinetics/*therapeutic use ; Male ; Middle Aged ; Thyroglobulin/*blood ; Thyroid Neoplasms/blood/radionuclide imaging/*radiotherapy ; *Whole Body Imaging

Objective: : To analyze the outcomes of coil embolization (CE) for unruptured intracranial aneurysm (UIA) according to region and hospital size based on National Health Insurance Service data in South Korea. Methods: : The incidence of complications, including intracranial hemorrhage (ICRH) and cerebral infarction (CI), occurring within 3 months and the 1-year mortality rates in UIA patients who underwent CE in 2018 were analyzed. Hospitals were classified as tertiary referral general hospitals (TRGHs), general hospitals (GHs) or semigeneral hospitals (sGHs) according to their size, and the administrative districts of South Korea were divided into 15 regions. Results: : In 2018, 8425 (TRGHs, 4438; GHs, 3617; sGHs, 370) CEs were performed for UIAs. Complications occurred in 5.69% of patients seen at TRGHs, 13.48% at GHs, and 20.45% at sGHs. The complication rate in TRGHs was significantly lower than that in GHs (p=0.039) or sGHs (p=0.005), and that in GHs was significantly lower than that in sGHs (p=0.030). The mortality rates in TRGHs, GHs, and sGHs were 0.81%, 2.16%, and 3.92%, respectively, with no significant difference. Despite no significant difference in the mortality rates, the complication rate significantly increased as the number of CE procedures per hospital decreased (p=0.001; rho=-0.635). Among the hospitals where more than 30 CEs were performed for UIAs, the incidence of CIs (p=0.096, rho=-0.205) and the mortality rates (3 months, p=0.048, rho=-0.243; 1 year, p=0.009, rho=-0.315) significantly decreased as the number of CEs that were performed increased and no significant difference in the incidence of post-CE ICRH was observed. Conclusion : The complication rate in patients who underwent CE for UIA increased as the hospital size and physicians’ experience in conducting CEs decreased. We recommend nationwide quality control policies CEs for UIAs.