OBJECTIVE: Adult onset Still s disease is an acute systemic inflammatory disorder. There are no pathognomonic symptoms or specific laboratory abnormalities. In recent reports, serum ferritin concentration is increased in active disease phase and decreased after defervescence. Our purpose was to determine the clinical significance of serum ferritin as an indicator for disease activity. METHODS: Seven patients who were diagnosed as adult onset Still s disease at Samsung Medical Center between October 1994 and March 1997, were reviewed. In these patients we checked leukocyte count, ESR, CRP and serum ferritin concentrations at the time of diagnosis and during follow-up periods and recorded febrile events during follow-up periods. RESULTS: At the time of diagnosis and during febrile periods, the concentrations of ferritin were extremely high(927ng/ml to 96,650ng/ml normal 10-290.8 ng/ml). The values were unrelated to other manifestations of the disease or laboratory findings. The ferritin concentrations decreased rapidly after adequate treatment. Eleven febrile reattacks happened in 7 patients. Serum ferritin concentrations were increased in 8 febrile attacks, while leukocyte count, ESR, and CRP were increased in 5, 5, 6 febrile attacks respectively, There were 10 events of increased serum ferritin concentrations in 7 patients during follow-up periods and 8 events were related with fever. The increases of other laboratory tests were similar. CONCLUSIONS: In all patients, serum ferritin concentrations were increased at the time of diagnosis and closely related to fever. During follow-up periods, serum ferritin concentrations are helpful in monitoring disease activity and guiding decisions about treatment.
Adult* ; Diagnosis ; Ferritins* ; Fever ; Follow-Up Studies ; Humans ; Leukocyte Count ; Still's Disease, Adult-Onset*

We measured the anterior chamber depth and chamber angle to understand the biological structure of anterior segment and find a possible relation between cataract and angle closure glaucoma on 235 eyes over 40 years old divided into two groups: 111 cataract eyes and 124 normal control eyes using the Scheimpflug Camera(EAS-1000, Nidek, Japan) and image analysis technique. The values of the anterior chamber depth and angle of the eye of the young person were greater than those of older person, and the values in the male were deeper(p<0.01) and larger(p<0.05) than those in female in both groups. In cata ract eyes, the mean anterior chamber depth was 2.77mm and mean anterior chamber angle was 30.36 degrees. The mean anterior chamber depth and angle of normal control eye were 2.67mm and 29.10 degrees. The anterior chamber depth and angle in cataract group was deeper(p<0.05) and larger(p<0.05) than in normal control group.
Adult ; Anterior Chamber* ; Cataract* ; Female ; Glaucoma, Angle-Closure ; Humans ; Male

Liver function tests before treatment showed abnormalities of liver function tests during treatment, while 15(68. 2%) of 22 patients who had abnormal liver function tests before treatment showed abnormalities during treatment. In 12 of the 25 patients who showed abnormalities of liver function tests during treatment with allopurinol, allopurinol was stopped and all patients showed improvement of liver function tests. In remaining 13 patients, 10 patients were improved and other 2 patients showed only mild abnormalities of liver function tests despite of continuing allopurinol and 1 patient was lost during follow-up. CONCLUSION: Abnormalities of liver function tests were common during treatment with allopurinol. Most patiensts who had mild abnormalities of liver functions tests during treatment with allopurinol were improved regardless of continuing allopurinol.
Allopurinol* ; Follow-Up Studies ; Gout* ; Humans ; Liver Function Tests* ; Liver*

Accidental ingestion of foreign body is a common problems in pediatric emergencies. The majority of such cases occur in children between 6 months and 3 years of age. 80% of ingested foreign bodies which reach the stomach will pass uneventfully through the gastrointestinal tract, however the remainder may cause obstruction, perforation or hemorrhage. When several magnets are ingested, they can be attracted to each other through the intestinal wall, causing necrosis and intestinal perforation or fistula, so they should be removed while they are still in the stomach. The authors experienced 2 cases of unusual small bowel complication caused by the ingestion of magnets. The first case was a 10-month-old male with ileal perforation due to 2 ingested magnetic beads, and the second case was a 22-month-old male with ileo-ileal fistula due to 7 ingested magnetic beads.
Child ; Eating* ; Emergencies ; Fistula ; Foreign Bodies* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Infant ; Intestinal Perforation ; Male ; Necrosis ; Stomach

No abstract available.
Rhinoplasty*

Popliteal vein aneurysm is a very uncommon and rarely reported although potentially life-threatening disease because it can be a source of pulmonary embolism. A patient with recurrent pulmonary embolism must be checked for lower extremity venous abnormalities. Recently, newer techniques including duplex scanning, computerized tomography and magnetic resonance imaging are useful in detecting popliteal fossa venous abnormalities. However, venography is also mandatory before operating on a popliteal vein aneurysm. Several methods are useful for the surgical treatment of popliteal vein aneurysms, including aneurysmectomy with lateral venorrhaphy, aneurysmectomy with vein transposition, aneurysmectomy with vein patch, etc. Following surgery, anticoagulation therapy is widely accepted. Here in, we present a case of popliteal vein aneurysm with pulmonary embolism. This patient was a 67-year-old woman exhibiting chest pain and exertional dyspnea. Lung scan and chest CT revealed multiple pulmonary embolisms and lower extremity venography revealed a right popliteal vein aneurysm with thromboembolism. This patient underwent aneurysmectomy with lateral venorrhaphy.
Aged ; Aneurysm* ; Chest Pain ; Dyspnea ; Female ; Humans ; Lower Extremity ; Lung ; Magnetic Resonance Imaging ; Phlebography ; Popliteal Vein* ; Pulmonary Embolism* ; Thromboembolism ; Tomography, X-Ray Computed ; Veins

BACKGROUND: A management protocol for hepatitis C virus (HCV) after liver transplantation (LT) has not been established in Korea. We therefore investigated HCV transplant protocols and post-transplant results from liver transplant centers in Korea. METHODS: The HCV protocol and medical data of individual cases from eight major liver transplant centers were compiled and analyzed. RESULTS: A post-transplant protocol biopsy was performed in only three centers. In these centers, HCV treatment was considered when pathological abnormalities were confirmed on the protocol biopsy (irrespective of liver function). In the other five centers, biopsies were performed when biochemical parameters were aggravated. Only two out of the eight centers performed preemptive or prophylactic therapy. A total of 5,663 adult LTs were performed between 2000 and 2010. HCV-related liver disease was responsible for 277 LTs (4.9%). Pre-transplant data were not available in many patients, including HCV genotype and serum HCV RNA level. Tacrolimus was more frequently used for initial maintenance immunosuppression than cyclosporine A (61.7% vs. 36.8%). Post-transplant HCV treatment was performed in 135 patients (48.7%). Sixty-seven recipients (24.2%) died during follow-up after LT and 11 HCV-related graft loss (4.0%) developed. The cumulative patient survival rate was 74.7% at 5 years and 67.9% at 10 years after LT. CONCLUSIONS: The HCV management protocol after LT varied markedly between the eight Korean transplant centers and a standard protocol did not exist. A nationwide multicenter study is required to investigate the most effective treatment for HCV after LT, with the goal of establishing the most effective standard protocol.
Adult ; Biopsy ; Cyclosporine ; Follow-Up Studies ; Genotype ; Hepacivirus ; Hepatitis ; Hepatitis C ; Humans ; Immunosuppression ; Korea ; Liver ; Liver Diseases ; Liver Transplantation ; RNA ; Survival Rate ; Tacrolimus ; Transplants

Intravascular papillary endothelial hyperplasia (Masson's hemangioma) is a disease characterized by exuberant endothelial proliferation within the lumen of medium-sized veins. In 1923, Masson regarded this disease as a neoplasm inducing endothelial proliferation, however, now it is considered to be a reactive vascular proliferation following traumatic vascular stasis. The lesion has a propensity to occur in the head, neck, fingers, and trunk. Occurrence within the abdominal cavity is known to be very rare, and especially in the liver, there has been no reported case up to date. The authors have experienced intravascular papillary endothelial hyperplasia of the liver in a 69-yr-old woman, and report the case with a review of the literature.
Aged ; Angiography ; Endothelium, Vascular/pathology ; Female ; Hemangioendothelioma/*pathology/surgery ; Human ; Liver/*blood supply/*pathology ; Necrosis ; Vascular Neoplasms/*pathology/surgery

PURPOSE: Pathogenesis of intraneural ganglion is controversial, however, the synovial theory that the intraarticular region is the origination of disease has come into the spotlight nowadays. But there are a few researches about intraneural ganglion in foot and ankle. We studied 7cases of intraneural ganglion. We are going to prove the synovial theory by indentifying articular branch of intraneural ganglion. MATERIALS AND METHODS: From August 2003 to May 2011, we evaluated 7 ouf of 8 patients diagnosed as a intraneural ganglion in foot and ankle. The gender ratio were 4 male and 3 female, and the mean age at the time of surgery was 52.9 years. Clinically, we checked pre and post operative symptom, muscle tone and whether loss of muscle tone and sensation exists. We analyzed surgical records and preoperative MRI and compared those with intra-operative finding. RESULTS: In MRI analysis of 7cases, the connection around the joints were confirmed, and 1 case was confirmed in the retrospective analysis of MRI. Intraneural ganglions occurred in medial plantar nerve 3 cases, lateral plantar nerve 1 case, superficial peroneal nerve 1 case and sural nerve 1 case. We could not found recurrence during the follow up periods. Most patients relieved pain after operation, but recovery of sensation was unsatisfactory. We could find some cases pathological finding of the nerve intraoperatively, and clinical result of that cases was poor. CONCLUSION: Intraneural ganglion can occur in various parts in foot and ankle. We concluded that the intranneural ganglion originated from joint by identifying the artichlar branch of ganglion. Due to its small size, it is difficult to find articular branch in operation field. But we do our best to find and remove articular branch. Currently, considering the small amount of research in foot and ankle, more research about articular brach is needed.
Animals ; Ankle ; Female ; Follow-Up Studies ; Foot ; Ganglion Cysts ; Humans ; Joints ; Male ; Muscles ; Organic Chemicals ; Peroneal Nerve ; Recurrence ; Retrospective Studies ; Sensation ; Sural Nerve ; Tibial Nerve

PURPOSE: Subtalar distraction arthrodesis is useful treatment option for restore hindfoot alignment. but, using structural autograft have high risk of donor site morbidity. Recently, by replacing the structural allograft has been reported satisfactory clinical results. Therefore, the authors reviewed the results of subtalar distraction arthrodesis using a structural allograft, retrospectively. MATERIALS AND METHODS: From January 2008 to May 2010, 12 patients (12 feets; 9 male, 3 female) underwent subtalar distraction arthrodesis using frozen structural allograft. 9 cases were calcaneal malunion, 2 were nonunion or malunion after subtalar arthrodesis, 1 was other cause. Mean age was 38.9 (12~66) years old and follow up period was 16.5 (12~36) months. Surgical was performed with posterolateral approach and tricortical allobone block of frozen femoral neck was used. Analysis was done with retorspective manner to evaluate preoperative, postoperative, and final follow up radiologic measurement and AOFAS ankle-hindfoot scale. RESULTS: There was statistically significant increase (p<0.05) of ankle-hindfoot scale from preoperative 27.5 points to postoperative 72.5 points, talocalcaneal height by 6.62 mm, calcaneal pitch angle by 5.73 degrees, lateral talocalcaneal angle by 6.38 degrees and significant decrease (p<0.05) of tali-1st metatarsal angle by 5.23 degrees. 11 feet (91.7%) acquired bony union and it takes average 5.1 months. Final post-operative result revealed talocalcaneal height changed by 2.57 mm, calcaneal pitch anble, lateral talocalcaneal angle, talar-1st metatarsal angle were changed by 2.63 degrees, 1.62 degrees, 1.18 degrees, respectively (p<0.05). 3 cases of partial osteonecrosis of posterior facet of calcaneus were observed in operation field, 4 cases of complication were developed (1 case of nonunion, 1 collapse of allobone graft, 1 screw loosening, 1 superficial skin necrosis). CONCLUSION: Subtalar distraction arthrodesis using frozen structural allobone graft is useful alternative treatment method of arthrodesis with structural autobone graft.
Arthrodesis ; Calcaneus ; Femur Neck ; Follow-Up Studies ; Foot ; Humans ; Male ; Metatarsal Bones ; Osteonecrosis ; Skin ; Tissue Donors ; Transplantation, Homologous ; Transplants