PURPOSE: To evaluate the diagnostic value of a lateral view of the ankles in Achilles tendon rupture. MATERIALS AND METHODS: We performed a retrospective analysis of the roentgenographic findings of 15 patients withsurgically proven Achilles tendon rupture. Four groups of 15 patients(normal, ankle sprain, medial lateralmalleolar fracture, and calcaneal fracture) were analysed as reference groups. Plain radiographs were reviewedwith regard to Kager's triangle, Arner's sign, Toygar's angle, ill defined radiolucent shadow through theAchilles tendon, sharpness of the anterior margin of Achilles tendon, and meniscoid smooth margin of the posteriorskin surface of the ankle. RESULTS: Kager's triangle was deformed and disappeared after rupture of theAchilles tendon in nine patients(60%) with operative verification of the rupture, six patients(40%) had a positiveArner's sign, while none had a diminished Toygars angle. In 13 patients(87%) with a ruptured Achilles tendon,the thickness of this was nonuniform compared with the reference group. The anterior margin of the Achilles tendonbecame serrated and indistinct in 14 patients(93%) in whom this was ruptured. An abnormal ill defined radiolucentshadow through the Achilles tendon was noted in nine patient(60%), and nonparallelism between the anterior marginof the Achilles tendon and posterior skin surface of the ankle was detected in 11 patients(73%). The posteriorskin surface of the ankle had a nodular surface margin in 13 patients(87%). CONCLUSION: A deformed Kager'striangle and Achilles tendon, and an abnormal ill defined radiolucent shadow through the Achilles tendon in alateral view of the ankles are important findings for the diagnesis of in diagnosing achilles tendon rupture.
Achilles Tendon* ; Ankle ; Ankle Injuries ; Humans ; Retrospective Studies ; Rupture* ; Skin ; Tendons

Hantavirus infection occuring during pregnancy is rarely progressing to adult respiratory distress syndrome (ARDS), which is accompanied by thrombocytopenia, leukocytosis, fever, oliguria, aggravation of bleeding, hematuria, lactacedemia. Pregnancy may have an unfavorable impact on the pathophysiologic characteristics of ARDS. The high oxygen demands of pregnancy are unable to be matched by oxygen delivery in ARDS and may predispose the patient to multiple organ failure, as well as fetal oxygen deprivation. We present the case with hantavirus pulmonary syndrome complicating pregnancy.
Fever ; Hantavirus Infections ; Hantavirus Pulmonary Syndrome* ; Hantavirus* ; Hematuria ; Hemorrhage ; Humans ; Leukocytosis ; Multiple Organ Failure ; Oliguria ; Oxygen ; Pregnancy* ; Respiratory Distress Syndrome, Adult ; Thrombocytopenia

No abstract available.
Glomerulonephritis, IGA* ; Immunoglobulin A* ; Korea*

PURPOSE: To evaluate the CT features of inflammatory pseudotumor of the liver with histopathologiccorrelation. MATERIALS AND METHODS: The CT features of 14 cases (ten patients) with pathologically proveninflammatory hepatic pseudotumor were retrospectively analyzed and correlated with resected and biopsy specimens. RESULTS: The size of lesions ranged between 2.0 and 7.0cm (mean, 3.7cm); On unenhanced CT, the masses were seenas ill-defined hypodense lesions, while on contrast-enhanced CT they were heterogeneous and multiseptated, withenhancement of internal septa and peripheral wall (n=10). In four lesions, central low density and peripheralhomogeneous enhancement were seen. On histopathological correlation, the central hypoattenuated area correspondedto chronic inflammalory cell infiltrates with foamy histiocytes, plasmacytes, and lymphocytes, while thehyperattenuated peripheral wall and internal septa represented dense fibrosis. CONCLUSION: In patients in whon CTshows a heterogeneous enhancing mass, inflammatory pseudotumor of the liver should be included in differentialdiagnosis.
Biopsy ; Fibrosis ; Granuloma, Plasma Cell* ; Histiocytes ; Humans ; Liver* ; Lymphocytes ; Plasma Cells ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To evaluate the quality of prehospital CPR (cardiopulmonary resuscitation) performed by 119 rescue personnel and bystanders in Seoul and to recognize the present problems in the pre-hospital emergency medical service system (EMS). METHODS: We enrolled all patients in cardiac arrest visiting the emergency rooms of 9 university hospitals in Seoul via 119 rescue services from 16 October to 26 November 2006, prospectively investigating the environments in which arrest occurred and the factors associated with CPR. RESULTS: Among 73 patients, the most common place of arrest was in the home(45.2%), CPR by bystander was performed in 8 cases(10.7%), endotracheal intubation by EMS personnel was performed in 10 cases(14.1%). Average time from call to CPR was 11.9 minutes and the number of discharges alive was 3 cases(4.1%). CONCLUSION: To improve the rate of alive discharges, development of CPR education program for lay rescue, education in basic and advanced life support, and management of quality for EMS personnel are needed.
Cardiopulmonary Resuscitation ; Emergencies ; Emergency Medical Services ; Heart Arrest ; Hospitals, University ; Humans ; Hypogonadism ; Intubation, Intratracheal ; Mitochondrial Diseases ; Ophthalmoplegia ; Out-of-Hospital Cardiac Arrest ; Prospective Studies

BACKGROUND/AIMS: Bone marrow-derived cells (BMDC) contribute to tissue maintenance under many kinds of pathologic conditions. We carried out a study to see how BMDC play a role in the treatment of experimental murine colitis. METHODS: We divided the animals into 3 groups and treated them with 50% ethanol (control group), 2,4,6-trinitrobenzene sulfinic acid colitis (TNBS group), and TNBS+bone marrow transplant (BMT group). To induce colitis, TNBS (5.0 mg/mouse) dissolved in 50% ethanol was injected into anus weekly for two weeks. Bone marrow transplantations were performed using bone marrow of male transgenic mouse (donor) with green fluoresence protein (GFP) into female wild type mouse (recipient) three weeks before TNBS instillation. All animals were sacrificed, and colons were extracted one week after the last TNBS instillation. We measured microscopic scores of mucosal injury and investigated the GFP expression for bone marrow engraftment. The immunostaining of vimentin and alpha-smooth muscle actin (alpha-SMA) for myofibroblasts was performed. RESULTS: The score of mucosal injury in the TNBS group was much more severe than those in control, and reduced significantly by BMT (p<0.05). GFP-positive cells were almost deposited in pericryptal niche of BMT group but not at all in both control and TNBS group. Most of myofibroblasts stained with both vimentin and SMA also infiltrated into pericryptal niche. But, the number of myofibroblasts stained with vimentin and SMA in both control and TNBS group was smaller than that in BMT group. CONCLUSIONS: BMDC deposited on pericryptal niche might have a significant role in repairing acute experimental murine colitis.
Actins/metabolism ; Acute Disease ; Animals ; *Bone Marrow Transplantation ; Colitis/chemically induced/pathology/*surgery ; Female ; Fibroblasts/cytology ; Intestinal Mucosa/cytology ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Transplantation, Homologous ; Trinitrobenzenesulfonic Acid/*toxicity ; Vimentin/metabolism

This correction is being published to correct the third author's Korean name.

BACKGROUND/AIMS: Signaling pathways via integrin-linked kinase (ILK) and beta-catenin are important in the initiation and progression of various malignant diseases. ILK modulates the transcription of beta-catenin and is implicated in cell migration and invasiveness. Recently, premalignant colon polyps were found to express ILK and beta-catenin. Therefore, we investigated the expression of ILK and beta-catenin in colon polyps according to the gross morphology and pathologic type. METHODS: Based on morphology, colon polyps (62) were classified as being a pedunculated polyp (Ip, 16), sessile polyp (Is, 22), or laterally spreading tumor (LST, 24). The colon polyps were classified pathologically as tubular adenomas (TAs, 47) and hyperplastic polyps (HPs, 15). The expression levels of ILK and beta-catenin in colon polyps and normal colon (6) were evaluated with immunohistochemistry. RESULTS: In normal colon, ILK was not expressed, and beta-catenin stained in the cell membrane only. Based on the gross morphology of the colon polyps, no significant difference was seen in the expression of ILK and beta-catenin (p>0.05). The expression of both ILK and beta-catenin in TAs was greater than that in HPs (p<0.01): the greater the dysplasia in TAs, the more both ILK and beta-catenin were expressed (p<0.05). The grade of expression of ILK was correlated with that of beta-catenin in colon polyps (p<0.01). CONCLUSIONS: The expression of ILK and beta-catenin did not differ according to the morphology of colon polyps, but was expressed more in TAs than in HPs, especially in severe dysplasia.
Adenoma ; beta Catenin ; Cell Membrane ; Cell Movement ; Colon ; Immunohistochemistry ; Phosphotransferases ; Polyps ; Protein-Serine-Threonine Kinases ; Proteins

BACKGROUND AND OBJECTIVES: Several predictors of recurrence of atrial fibrillation (AF) after ablation have been identified, including age, type of AF, hypertension, left atrial diameter and impaired left ventricular ejection fraction. The aim of this study was to investigate whether the atherosclerotic plaque thickness of the thoracic aorta is associated with a recurrence of AF after circumferential pulmonary vein ablation (CPVA). SUBJECTS AND METHODS: Among patients with drug-refractory paroxysmal or persistent AF, 105 consecutive (mean age 58+/-11 years, male : female=76 : 29) patients who underwent transesophageal echocardiography and CPVA were studied. The relationships between the recurrence of AF and variables, including clinical characteristics, plaque thickness of the thoracic aorta, laboratory findings and echocardiographic parameters were evaluated. RESULTS: A univariate analysis showed that the presence of diabetes {hazard ratio (HR)=3.425; 95% confidence interval (CI), 1.422-8.249, p=0.006}, ischemic heart disease (HR=4.549; 95% CI, 1.679-12.322, p=0.003), duration of AF (HR=1.010; 95% CI, 1.001-1.018, p=0.025), type of AF (HR=2.412, 95% CI=1.042-5.584, p=0.040) and aortic plaque thickness with > or =4 mm (HR=9.514; 95% CI, 3.419-26.105, p<0.001) were significantly associated with the recurrence of AF after ablation. In Cox multivariate regression analysis, only the aortic plaque thickness (with > or =4 mm) was an independent predictor of recurrence of AF after ablation (HR=7.250, 95% CI=1.906-27.580, p=0.004). CONCLUSION: Significantly increased aortic plaque thickness can be a predictable marker of recurrence of AF after CPVA.
Aorta, Thoracic ; Atherosclerosis ; Atrial Fibrillation ; Catheter Ablation ; Echocardiography, Transesophageal ; Humans ; Hypertension ; Male ; Myocardial Ischemia ; Plaque, Atherosclerotic ; Pulmonary Veins ; Recurrence ; Stroke Volume

BACKGROUND/AIMS: The serum cytokeratin-18 (CK-18) has been suggested to be a surrogate marker of non-alcoholic fatty liver disease (NAFLD). The aim of this study was to investigate the correlation between CK-18 and metabolic parameter in NAFLD patients. Correlation between CK-18 and macronutrient composition was also assessed. METHODS: A total of 212 subjects were recruited. Blood chemistry including fasting glucose, cholesterol level, AST, ALT, and CK-18 were compared. Data on calorie intake and carbohydrate consumption were acquired by five-day-diet diary using 24 hour recall method. RESULTS: Plasma CK-18 were markedly increased in patient with NAFLD compared with control group (420.4+/-282.3 vs. 313.6+/-179, p<0.001). Plasma CK-18 were positively correlated with systolic blood pressure (r=0.130), ALT (r=0.503) and negatively correlated with HDL cholesterol (r=-0.246). NAFLD patients with metabolic syndrome had higher CK-18 level than those without metabolic syndrome (484.0 vs. 372.1 U/L, p=0.021). When NAFLD patients were subdivided into two groups with CK-18 cut-off value of 400 U/L, patients with CK-18 level over 400 U/L showed higher body mass index (28.0+/-4.5 vs. 25.5+/-4.3), subcutaneous abdominal fat (283.5+/-172.2 vs. 195.7+/-147.8), AST (52.7+/-26.3 vs. 40.7+/-23.5) and ALT (102.0+/-52.6 vs. 61.2+/-32.2). Calorie intake (r=0.301) and carbohydrate intake (r=0.305) also showed positive correlation with CK-18. CONCLUSIONS: Plasma CK-18 showed positive correlation with metabolic parameters as well as calorie and carbohydrate intake when its cut-off value of greater than 400 U/L was used.
Abdominal Fat ; Biological Markers ; Blood Pressure ; Body Mass Index ; Carbohydrates ; Chemistry ; Cholesterol ; Cholesterol, HDL ; Fasting ; Fatty Liver* ; Glucose ; Humans ; Keratin-18* ; Plasma ; Ultrasonography*