No abstract available.
Alopecia* ; Hair* ; Humans ; Male* ; Tissue Expansion*

Clavicular fracture is common injury in the upper extremity, but ipsilateral proximal, distal or middle-third clavicular fractures which occur simultaneously are an extremely rare. Seven cases have been reported in the English and Japanese literatures, but it has never been reported in Korea. We report a case of ipsilateral proximal and distal clavicular fracture caused by fall from height and describe its presumed mechanism, diagnosis, treatment with a review of literatures.
Asian Continental Ancestry Group ; Clavicle ; Humans ; Korea ; Upper Extremity

BACKGROUND: The aim of this study was to evaluate the sensory and motor nerve block achieved by epidural anesthesia using 0.475% ropivacaine and 0.75% ropivacaine. METHODS: Fifty-six patients undergoing cesarean section were randomly allocated to group I (0.75% ropivacaine) or group II (0.475% ropivacaine). We assessed changes in sensory and motor block using the Bromage scale over 180 minutes after epidural anesthesia. The incidence of nausea, vomiting and the total dosage of ephedrine used were also recorded. Sensory changes, motor blockade and the total dosage of ephedrine used were compared using the t-test (P < 0.05). RESULTS: No significant differences were found between the two groups at the sensory block level except at 30 and 60 minutes after epidural anesthesia. However, the motor blockade of group I was significantly more intense than that of group II at 15, 20, 25, 30, 60, 120 and 180 minutes after epidural anesthesia. No significant differences were observed between the two groups in the incidences of nausea, vomiting or the total dosage of ephedrine used. CONCLUSIONS: The use of 0.475% ropivacaine instead of 0.75% ropivacaine in epidural anesthesia for cesarean section did not reduce the incidence of nausea, vomiting or the total dosage of ephedrine used. The sensory block achieved using 0.75% ropivacaine was similar, but the motor blockade achieved using 0.475% ropivacaine was less intense with a shorter duration and an earlier recovery to normal than that of 0.75% ropivacaine. These results suggest that 0.475% ropivacaine may be more useful in epidural anesthesia for cesarean section than 0.75% ropivacaine.
Anesthesia, Epidural* ; Cesarean Section* ; Ephedrine ; Female ; Humans ; Incidence ; Nausea ; Nerve Block* ; Pregnancy ; Vomiting

Mosaic trisomy 14 syndrome is a well-known but unusual chromosomal abnormality with a distinct and recognizable phenotype. Array comparative genomic hybridization (CGH) analysis has recently become a widely used method for detecting DNA copy number changes, in place of traditional karyotype analysis. However, the array CGH shows a limitation for detecting the low-level mosaicism. Here, we report the detailed clinical and cytogenetic findings of patient with low-frequency mosaic trisomy 14, initially considered normal based on usual cut-off levels of array CGH, but confirmed by G-banding karyotyping. Our patient had global developmental delay, short stature, congenital heart disease, craniofacial dysmorphic features, and dark skin patches over her whole body. Estimated mosaicism proportion was 23.3% by G-banding karyotyping and 18.0% by array CGH.
Chromosome Aberrations ; Chromosomes, Human, Pair 14 ; Comparative Genomic Hybridization ; Cytogenetics ; DNA Copy Number Variations ; Heart Diseases ; Humans ; Hypogonadism ; Intellectual Disability ; Karyotype ; Karyotyping ; Mitochondrial Diseases ; Mosaicism ; Ophthalmoplegia ; Phenotype ; Skin ; Trisomy

Hemorrhagic radiation proctitis is infrequently seen in patients receiving pelvic irradiation. The treatment of hemorrhagic ralation proctitis is often difficult. Many patients need reyeated hospitalizations and blood transfusions. Occasionally patiets will develop severe or recurrent rectal bleeding. In case of massive bleeding requiring excessive transfusion, colonic diversion by construction of a colostomy or excision of the diseased segment may be inevitable. However, surgical procedures in these patients are associated with a high mortality and morbidity. Moreover, medical therapy is usually ineffective. Recently formalin therapy has been introduced as a simple and effective treatment for hemorrhagic radiation proctitis. We experienced a 69 year-old woman patient who developed severe homorrhagic proctitis 1 year after radiotherapy for carcinoma of the cervix. She had not improved by conservative management and required blood tranafusions and repetitive hospitalizations. After local application of a 4% formalin solution in the diseased rectum under caudal anesthesia, the bleeding immediately stopped and the patient was discharged from the hospital, and no recurrence has been observed until now.
Aged ; Anesthesia, Caudal ; Blood Transfusion ; Cervix Uteri ; Colon ; Colostomy ; Female ; Formaldehyde* ; Hemorrhage ; Hospitalization ; Humans ; Mortality ; Proctitis* ; Radiotherapy ; Rectum ; Recurrence

Epidermal growth factor receptor(EGFR) mRNA was assessed in 7, 12-dimethylbenz(a) anthracene(DMBA)-induced squamous cell carcinomas(SCC) in the hamster buccal pouch model to elucidate the role and timing of histologic changes and differentiation during carcinogenesis. In situ reverse-transcriptase polymerase chain reaction was used to identify the EGFR. DMBA(0.5%) in heavy mineral oil was applied to the right buccal pouch 3 times per week for up to 16 weeks. Hyperplasia was detected by histologic analysis at 4 weeks, dysplasia with or without papillomatous changes at 8 weeks, and SCC at 16 weeks. Paraffin embedded sections of the tumors were used for EGFR mRNA and immunohistochemical determinations. EGFR cDNA was synthesized in situ by reverse transcription using an EGFR-specific oligonucleotide primer. In situ PCR amplification in the presence of digoxigenin-11-dUTP and subsequent binding with an antidigoxigenin antibody conjugated to alkaline phosphatase allowed direct visualization. EGFR mRNA was localized in the nuclei of the basal cell layer of normal squamous epithelium but is expanded to the superficial squamous cell layer as well as the basal cell layer in hyperplasia and dysplasia and is diffusely expressed in squamous cell carcinoma. EGFR protein, detected by immunostaining using a monoclonal antibody, was expressed mainly in the cytoplasm of superficial squamous cell layers(not in the basal cell layer) in normal squamous epithelium. It increased gradually in level and amount through the stages of hyperplasia and dysplasia to invasive squamous cell carcinoma. These results suggest that the biological markers EGFR mRNA and EGFR protein may be used for assessing intermediate end points in tests of various chemopreventive agents on oral carcinogenesis in the hamster buccal pouch model as well as in human clinical trials.
Alkaline Phosphatase ; Animals ; Biomarkers ; Carcinogenesis ; Carcinoma, Squamous Cell* ; Cricetinae* ; Cytoplasm ; DNA, Complementary ; Epidermal Growth Factor* ; Epithelium ; Humans ; Hyperplasia ; Mineral Oil ; Paraffin ; Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor* ; Reverse Transcriptase Polymerase Chain Reaction* ; Reverse Transcription ; RNA, Messenger ; RNA-Directed DNA Polymerase*

Purpose: Acetaminophen overdose accounts for the largest proportion of pediatric poisoning reported in South Korea. We investigated the characteristics and prognosis of pediatric acetaminophen overdose. Methods: We retrospectively reviewed medical records of patients younger than 19 years with acetaminophen overdose who visited the emergency department (ED) of Pusan National University Children’s Hospital from January 2009 through December 2022. We investigated age, sex, dose, clinical findings, and treatment, and compared the differences in the variables according to the intentionality of ingestion and the presence of hepatotoxicity. Results: Among the 132,691 pediatric patients who visited the ED during the period, 555 did for drug intoxication, of whom 51 with acetaminophen overdose were included in this study. The overdose was intentional in 43 patients (the intentional group; median age, 15.4 years [interquartile range, 13.9-16.8]) and accidental in 8 patients (the accidental group; 7.7 years [2.3-15.4]). The mean ingested dose was higher in the intentional group than in the accidental group (170.3 ± 129.0 vs. 105.3 ± 37.5 mg/kg; P = 0.016). Hospitalization tended to be implemented more frequently in the intentional group (53.5% vs. 12.5%; P = 0.081). All patients with hepatotoxicity (n = 10) belonged to the same group, and showed a higher or longer median age (15.9 [14.6-17.1] vs. 13.8 years [13.7-16.4]; P = 0.030), mean ingested dose (13,230.0 ± 10,544.8 vs. 7,654.0 ± 6,752.3 mg; P = 0.043), mean time from ingestion to arrival at the ED (22.6 ± 23.4 vs. 5.5 ± 6.4 hours; P = 0.048), and frequency of hospitalization (80.0% vs. 39.0%; P = 0.048). Conclusion It is necessary to track the occurrence of hepatotoxicity in patients who intentionally ingest acetaminophen.

PURPOSE: Retrograde intramedullary nailing has been recommended as one of the treatment options for the distal femoral fracture, particularly in patients who are obese, are pregnant, has sustained ipsilateral femoral neck fracture, have multiple injuries. However there are some disadvantage such as post-arthrotomy infection, knee joint stiffness. This paper is to evaluate the result and complication of treatment of distal femoral fracture with a retrograde intramedullary nailing. MATERIALS AND METHODS: We reviewed 13 cases (distal femoral shaft fracture: 6 cases, supracondylar fracture: 7 cases) of the distal femoral fracture who had been treated with retrograde intramedullary nailing and follow up for more than 12 months from January 1999 to December 2001. The rate of bony union, range of motion of the knee, complications were evaluated. RESULTS: The mean duration of bony union was 20 weeks (range, 16~25 weeks). A case of delayed union was developed. In 4 cases of 13 cases showed posterior angulation below 6 degree, which did not need further treatment. According to Saunder's criteria, excellent result was achieved in 8 patients, good result in 5 patients, respectively. CONCLUSION: This study showed good clinical and radiological results of union with retrograde intramedullary nailing at the distal femoral fracture and ipsilateral multiple fracture
Femoral Fractures ; Femoral Neck Fractures ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Humans ; Knee ; Knee Joint ; Multiple Trauma ; Range of Motion, Articular

PURPOSE: To determine whether Tc-99mMIBI is recognized by the multidrug resistant P-glycoprotein (Pgp), we have measured quantitatively Tc-99mMIBI uptake in cancer cells. The effects of various Pgp reversing agents on cellular Tc-99m-MIBI uptake were also investigated in the presence of multidrug resistance gene-1 (mdr1 gene) overexpression. MATERIALS AND METHODS: We measured percentage uptake of Tc-99m-MIBI at different incubation temperatures both in mdr1 positive and negative cells. The effects of verapamil, cyclosporin, and dipyridamole on cellular uptake of Tc-99m-MIBI were also evaluated with or without overexpression of mdr1 gene in cultured murine leukemia L1210 cells. RESULTS: The mdr1 gene expressing cell lines were effectively induced in in vitro with continuous application of low-dose adriamycin or vincristine. Cellular uptake of Tc-99m-MIBI was higher in mdr1 negative L1210 cells than those of mdr1 positive cells, and higher when incubated in 37 degree C than 4 degree C. In the presence of verapamil, cyclosporin or dipyridamole, Tc-99m-MIBI uptake was increased upto 604% in mdr1 positive cells. CONCLUSION: Cellular uptake of Tc-99m-MIBI is lower in leukemia cells over-expressing mdr1 gene, and MDR-reversing agents increase cellular uptake. These results suggest that Tc-99m-MIBI can be used for characterizing Pgp expression and developing MDR-reversing agents In vitro.
Animals ; Cell Line ; Cyclosporine ; Dipyridamole ; Doxorubicin ; Drug Resistance, Multiple* ; Leukemia L1210 ; Leukemia* ; P-Glycoprotein ; Technetium Tc 99m Sestamibi* ; Verapamil ; Vincristine

New surgical techniques utilizing computer-aided engineering have been recently developed to improve the quality of surgery and reduce the risk to patients. This paper reports the surgical cases using rapid prototyping assisted orthopeadic fracture surgery (RPAOFS). RPAOFS utilizes the symmetric characteristics of the human body, and the potential for RE and RP in which the physical shape is manufactured repidly from the CT data. The physical shape before the injury was manufactured from the RP using the mirror transformed CAD data of the uninjured extents. Subsequently, pre-operative planning, such as the selection of the proper implant, preforming of the implant, selection of the fixation positions, and surgery are performed utilizing the physical shape. RPAOFS was applied to two cases such as a distal tibia communited fracture and a proximal tibia plateau fracture. The surgical results showed that RPAOFS is an effective surgical tools.
Human Body ; Humans ; Surgery, Computer-Assisted ; Tibia