No abstract available.
Epithelioid Cells* ; Sacrum*

BACKGROUND: A medulloblastoma is a primitive neuroepithelial tumor of the cerebellum that occurs in children and metastasizes through the cerebrospinal fluid. It is highly malignant and invasive, and the 5-year survival rate is only 60%. Surgical resection techniques, radiation, and chemotherapy have improved the overall survival but the patients suffer life-long cognitive dysfunctions or endocrine abnormalities as the side effects of treatment. Therefore it is essential to identify prognostic markers to determine the appropriate treatment strategy in order to minimize the side effects. METHODS: This study evaluated the immunohistochemical differentiation and survival rate with synaptophysin, glial fibrillary acidic protein, epithelial membrane antigen, vimentin and primitive neuroepithelial marker nestin of 55 paraffin-embedded medulloblastomas, using a tissue microarray. The expression of survivin, the apoptotic inhibitor, and the survival rate with regard to the proliferation index of Ki-67 were also investigated. RESULTS: The group testing positive to vimentin, a mesenchymal differentiation marker, had a worse prognosis and there was a strong correlation between vimentin expression and nestin expression. Patients with a survivin expression rate >35% had a significantly poorer clinical course and there was a correlation between the survivin expression rate and Ki-67 expression rate. CONCLUSION: In conclusion, vimentin and survivin are negative prognostic markers in medulloblastomas.
Cerebellum ; Cerebrospinal Fluid ; Child ; Drug Therapy ; Glial Fibrillary Acidic Protein ; Humans ; Medulloblastoma* ; Mucin-1 ; Nestin ; Neuroectodermal Tumors, Primitive ; Prognosis ; Survival Rate ; Synaptophysin ; Vimentin*

Epithelium ; Humans ; Hyperplasia ; Lymphangiectasis ; Lymphangioma ; Lymphatic Vessels ; Male ; Molar, Third ; Salivary Glands ; Salivary Glands, Minor ; Tooth Extraction ; Young Adult

Acinar Cells ; Biopsy ; Carcinoma, Acinar Cell ; Diagnosis ; Humans ; Male ; Maxillary Sinus ; Middle Aged ; Odontogenic Tumors ; Recurrence

This paper is aimed to study the incidence, age and sex distribution, and type of lateral meniscal lesion including discoid meniscus in Korea. It is reported higher incidence of lateral meniscal lesion in Korea. 132 cases with meniscal lesions were surgically treated at the Department of Orthopedic Surgery, Seoul National University Hospital between 1973 and 1982. Of the 98 patients who had lateral meniscal lesions, forty-four (44.9%) were found to have a discoid meniscus. The mean age of the patients with discoid meniscus was 17.9 years, and 30 patients of them were younger than 20 years of age. The patients with discoid meniscus were followed after meniscectomy for an average of 6 months. The summary of this study are as follows: l. Over-all incidence of discoid meniscus were 44 cases (33.3%) out of 132 cases of the meniscal disease. All forty-four cases had a lateral discoid meniscus, and they formed 44.9% among 98 cases of lateral meniscal injury. 2. The discoid meniscus was most frequent in the age group between 11 and 20 years old (65.9%), and was more prevalent in female by a ratio of 1.4. 3. Qf the 26 patients with torn discoid meniscus, twelve (46.2%) denied the history of trauma. 4. Symptom of click sound was present in 42 cases (95.5%), and the rate of positive McMurray sign was 81.8%.
Clinical Study ; Female ; Humans ; Incidence ; Korea ; Orthopedics ; Seoul ; Sex Distribution

PURPOSE: To evaluate the clinical characteristics of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures and assess the surgical outcomes of a novel, closed intramedullary nailing surgical approach designed to minimize fixation failure. MATERIALS AND METHODS: Between May 2013 and April 2017, 31 patients with intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures treated with closed intramedullary nailing or long proximal femoral nail antirotation (PFNA) were enrolled in this study. Preoperative data included age, sex, injury severity score, body mass index, location of shaft fracture, injury mechanism, accompanying traumatic injury, walking ability before injury, and surgical timing. Perioperative outcomes, including follow-up period, types of intramedullary nails, number of blocking screws used, operation time, and blood loss were assessed. Radiologic outcomes, including union rate, time from surgery to union, and femoral shortening, and clinical outcomes, including hip flexion, walking ability, and Harris hip score were also evaluated. RESULTS: A total of 29 unions (93.5%) were achieved. The time to union was 16.8 months (range, 11–25 months) for hip fractures (15.7 weeks for intertrochanteric fractures and 21.7 weeks for subtrochanteric fractures) and 22.8 months for femoral shaft fractures. There were no significant differences in surgical outcomes between the two groups except for type of intramedullary nail. CONCLUSION: Closed intramedullary nailing in the treatment of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures may be a good surgical option. However, fixation of femoral shaft fractures might not be sufficient depending on the implant design.
Body Mass Index ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip ; Hip Fractures ; Humans ; Injury Severity Score ; Walking

PURPOSE: To assess the diagnostic efficacy of macular and peripapillary retinal thickness measurements for the staging of diabetic retinopathy (DR) and the prediction of disease progression. METHODS: In this prospective study, 149 diabetic patients (149 eyes) and 50 non-diabetic control subjects were included. Baseline optical coherence tomography was employed to measure retinal thickness in the macula (horizontal, vertical, and central) and the peripapillary zone (superior, inferior, nasal, and concentric to the optic disc). Seven baseline parameters were correlated with the DR stages identified by fluorescein angiography. Baseline retinal thickness was compared between groups of patients requiring panretinal photocoagulation (PRP) within 6 months (PRP group) and patients not requiring PRP (No-PRP group). RESULTS: Macular and peripapillary retinal thicknesses in diabetic subjects were significantly greater than that in normal controls (p<0.05). All retinal thickness parameters, and particularly peripapillary circular scans, tended to increase with increasing DR severity (p<0.05). The baseline thicknesses of the peripapillary circular scans were greater in the PRP group than in the no-PRP group (p<0.05). CONCLUSIONS: Peripapillary retinal thickness may prove to be a useful criterion for DR severity and may also serve as an indicator of disease progression.
Aged ; Diabetic Retinopathy/*diagnosis/surgery ; Disease Progression ; Female ; Fluorescein Angiography ; Humans ; Light Coagulation ; Male ; Middle Aged ; Optic Disk ; Prospective Studies ; Retina/*pathology/surgery ; *Severity of Illness Index ; *Tomography, Optical Coherence

To check expert opinion about the investigation system of medicine-related death, model for "Death Investigation Center" was suggested and related questionnaire were requested. Between 15 December 2009 and 5 April 2010, we sent e-mails of the questionnaire which asked the opinion for the new postmortem investigation system. We sent the questionnaire to 3,289 lawyers and 4,523 doctors (total 7812), and received 100 replies out of the total. All the lawyers and doctors interviewed knew the importance of the postmortem investigation system. Most of them (87%) agreed to the introduction of the new postmortem investigation system. Some of them thought that protector's agreement was necessary for the postmortem investigation (21%), and more doctors were likely to participate with legal protocol (23%). If the postmortem investigation could not be performed due to the protector's disagreement, another specialized medical investigation should be needed to figure out the cause of death (85%). The new postmortem investigation system should be performed by the specific institution, and supported by the government (44%). In many expert's opinion, nonmedical experts such as lawyers and priests should be included for the institution of investigation for objectivity and neutrality (72%). This sample study finds that the postmortem investigation performed by specialized institution is necessary to determine the cause of death in the hospital. For the operation of the system, neutrality and the operating core would be the most important.
Cause of Death ; Electronic Mail ; Expert Testimony ; Humans ; Lawyers ; Surveys and Questionnaires

No abstract available.
Hemorrhage*

The zygomaticomaxillary complex (ZMC) functions as a buttress for the face and is the cornerstone to a person's aesthetic appearance, by both setting the midfacial width and providing prominence to the cheek. Malar deficiency is often acquired by blunt injury incurred in a traumatic accident, resulting in ZMC fracture. A 48-year-old male patient presented a right ZMC fracture after contusion injury by a baseball. He only received conservative management and later he suffered discomfort during mouth opening at the moment of mastication, due to trismus involving the temporomandibular joint. In the current case, we describe a surgical technique, by which the malar body is shifted anteriorly and laterally after combined oblique-vertical osteotomy. The technique presented, eventually restored the former aesthetic position of the malar complex and symmetry, and, moreover, improved mastication function.
Baseball ; Cheek ; Contusions ; Fractures, Malunited ; Humans ; Male ; Mastication ; Middle Aged ; Mouth ; Osteotomy* ; Temporomandibular Joint ; Transplants* ; Trismus ; Wounds, Nonpenetrating