Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
Cardiomyopathies* ; Catecholamines ; Child, Preschool ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Hypertension ; Myocarditis ; Neuroblastoma*

OBJECTIVE: To describe the findings of videofluoroscopic study (VFSS) and investigate the usefulness of VFSS as a predictor of aspiration pneumonia in infants with aspiration symptoms. METHOD: Thirty-eight infants with aspiration symptoms were divided into two groups: those who showed aspiration symptom but had no pneumonia (Aspiration group); those with episode of aspiration pneumonia (Pneumonia group). The subjects' medical records and the results of VFSS were reviewed. RESULTS: In aspiration group, oral phase was normal and the abnormalities were found only in pharygeal phase in a small number of subjects. On the other hand, pneumonia groups showed poor lip closure and bolus formation in oral phase. Abnormalities of pharyngeal phase were reduced laryngeal elevation, coating of pharyngeal wall, increased residue of valleculae, and delay of pharyngeal transit time. Penetration and aspiration were more frequently observed (p <0.05). Aspiration pneumonia occurred more frequently among infants who had supraglottic penetration (p <0.05). CONCLUSION: Mild abnormalities were found only in pharyngeal phase in aspiration group, whereas VFSS abnormalities were observed in both oral and pharyngeal phase in infants with pneumonia. Our results suggest that VFSS would be useful in predicting the development of pneumonia in infants with aspiration symptoms.
Deglutition Disorders ; Fluoroscopy ; Hand ; Humans ; Infant ; Lip ; Medical Records ; Pneumonia ; Pneumonia, Aspiration

OBJECTIVE: To confirm the improvement in arterial endothelial function by aerobic exercise training, flow-mediated dilation (FMD) was tested by ultrasonography. METHODS: Patients who received percutaneous coronary intervention due to acute coronary syndrome were included. The patients who participated in cardiac rehabilitation (CR) program were categorized as the CR group, and others who did not participate as the control. Both groups underwent initial graded exercise test (GXT) and FMD testing. Subsequently, the CR group performed aerobic exercise training sessions. Patients in control only received advice regarding the exercise methods. After six weeks, both groups received follow-up GXT and FMD testing. RESULTS: There were 16 patients in each group. There were no significant differences in the general characteristics between the groups. The VO2peak was 28.6+/-4.7 mL/kg/min in the CR group and 31.5+/-7.4 mL/kg/min in the control at first GXT, and was 31.1+/-5.1 ml/kg/min in the CR group and 31.4+/-6.0 ml/kg/min in the control at the follow-up GXT in six weeks. There was a statistically significant improvement in VO2peak only for CR group patients. FMD value was 7.59%+/-1.26% in the CR group, 7.36%+/-1.48% in the control at first and 9.46%+/-1.82% in the CR group, and 8.31%+/-2.04% in the control after six weeks. There was a statistically significant improvement in FMD value in the CR group. CONCLUSION: According to the results of GXT and FMD testing, six-week exercise-based CR program improved VO2peak and endothelial functions significantly. Thus, exercise-based CR program is necessary in patients with coronary artery disease.
Acute Coronary Syndrome* ; Coronary Artery Disease ; Endothelial Cells ; Exercise Test ; Exercise* ; Follow-Up Studies ; Humans ; Percutaneous Coronary Intervention ; Rehabilitation ; Ultrasonography

Background: Although most studies focused on the alignment or union of the tibia in same-level distal third tibiofibular fractures, the outcome of a concomitant fibular fracture is generally regarded as being of secondary importance in the literature. This study aimed to assess the outcomes of fibular fractures in same-level distal third tibiofibular fractures. Methods: In this retrospective study, we enrolled 111 patients with same-level distal third tibiofibular fractures treated at our institute between January 2016 and August 2020. Tibial fractures were stabilized with intramedullary nailing, and the cases were divided into two groups based on whether they additionally underwent fibular fixation (group 1, 57 cases) or not (group 2, 54 cases). Clinical and radiographic outcomes were used for the evaluation of tibial and fibular alignments, union of the tibia and fibula, number of interlocking screws in the distal tibial fragment, range of motion of the ankle joint, and complications. Results: No statistically significant differences in the tibial union rate or mean tibial alignment were observed between the two groups on either the immediate postoperative or final radiographs. The fibular union rate in group 1 was significantly higher than that in group 2 (fibular nonunion, 0 vs. 15; p < 0.001). Statistically significant differences in fibular displacement were observed on immediate postoperative radiographs between patients with fibular union and those without it. At the final follow-up, the mean range of ankle motion and lower extremity functional scale scores did not differ between the two groups. Conclusions Regardless of whether fibular fixation was performed, the overall tibial alignment with intramedullary nailing was well restored and the union rate of the tibia was comparable in the two groups. Fibular nonunion is not uncommon in unfixed fibula fractures. Displacement of the fibula as seen on immediate postoperative radiographs was related to fibular nonunion.

OBJECTIVE: The purpose of this study is to prove and quantify motor tract disruption and to correlate with motor weakness and its recovery in thalamic and putaminal hemorrhage using diffusion tensor magnetic resonance(MR) image. METHODS: We studied 24 patients with thalamic and putaminal hemorrhage with motor weakness who did not underwent surgery(hematoma volume < 25ml). We performed diffusion tensor MR image within a week, and then calculated FA(fractional anisotropy) index and FA ratio of posterior limb of internal capsule. We checked motor power of the patients at initial, 2 weeks, 1 month, 3 months and 6 months after hemorrhage. We divided patients into three groups according to FA ratio(group A: FA ratio < 50.0%, group B: FA ratio 50.0~75.0%, group C: FA ratio > 75.0%)and compared means of motor power at each time. RESULTS: The means of FA ratio were 42.5% in group A, 63.0% in group B and 88.2% in group C. The means of motor power were 1.1, 2.3 and 3.7 at initial. After 6 months the means of motor power were 3.0, 4.0 and 4.5. The group of lower FA ratio had more severe motor weakness and showed worse motor recovery clinically than the group of higher FA ratio(P < 0.01). Though patients had severe motor weakness initially, the patients with high FA ratio showed good recovery. CONCLUSION: In thalamic and putaminal hemorrhage, diffusion tensor MR image can prove the degree of motor tract damage and predict the degree of motor recovery.
Diagnosis* ; Diffusion* ; Extremities ; Hemorrhage ; Humans ; Internal Capsule ; Magnetic Resonance Imaging* ; Putaminal Hemorrhage*

Bilateral sagittal split ramus osteotomy is considered a standard technique in mandibular orthognathic surgeries to reduce unexpected bilateral stress in the temporomandibular joints. Unilateral sagittal split ramus osteotomy (USSO) was recently introduced to correct facial asymmetry caused by asymmetric mandibular prognathism and has shown favorable outcomes. If unilateral surgery could guarantee long-term postoperative stability as well as favorable results, operation time and the incidence of postoperative complications could be reduced compared to those in bilateral surgery. This report highlights three consecutive cases with long-term follow-up in which USSO was used to correct asymmetric mandibular prognathism. Long-term postoperative changes in the condylar contour and ramus and condylar head length were analyzed using routine radiography and computed tomography. In addition, prior USSO studies were reviewed to outline clear criteria for applying this technique. In conclusion, patients showing functional-type asymmetry with predicted unilateral mandibular movement of less than 7 mm can be considered suitable candidates for USSO-based correction of asymmetric mandibular prognathism with or without maxillary arch surgeries.
Facial Asymmetry* ; Follow-Up Studies ; Head ; Humans ; Incidence ; Orthognathic Surgery ; Osteotomy, Sagittal Split Ramus* ; Postoperative Complications ; Prognathism ; Radiography ; Temporomandibular Joint

PURPOSE: To compare the mechanical effectiveness between performing conventional partial patellectomy and the separate vertical wiring technique for a comminuted fracture of the inferior pole of the patella. MATERIALS AND METHODS: Twenty patellae from cadavers (ten pairs) were used to model acute comminuted fractures of the inferior pole of the patella. Comminuted fractures of the inferior pole of the patellae were made by an oscillating saw. Then they were fixed with separating vertical wiring on one side and the other side received a partial patellectomy by the pull-out suture technique. We measured the maximal lengths between the superior and inferior poles of the normal patella and after fixation. A biomechanical test was then performed to compare the strength of fixation in the two group. RESULTS: The lengths of patella in the separate vertical wiring group (mean: 5.63 cm) were longer than those in the partial patellectomy group (5.24 cm). The maximal strengths of fixation in the separate vertical wiring (mean: 250.1 Newtons) were higher than in the partial patellectomy (mean: 69.7 Newtons). CONCLUSION: A separate vertical wiring is an effective method for fixation of the comminuted fracture of the inferior pole of the patella.
Cadaver ; Fractures, Comminuted* ; Knee ; Patella* ; Suture Techniques

No abstract available.
Splenomegaly*

Background: Blastocystis is a genus of intestinal, anaerobic protozoan parasites that can be isolated from humans, animals, and the environment. We aimed to determine the distribution of Blastocystis and subtypes (STs) using stool samples obtained from healthy volunteers at collection centers in South Korea. Methods: A total of 478 stool samples from volunteers were collected at five collection centers throughout South Korea. The presence of Blastocystis was determined using PCR based on the small subunit (SSU) rRNA gene, and Blastocystis STs were confirmed through sequencing of the SSU rRNA gene. Results: Molecular analysis revealed the presence of Blastocystis in 27 (5.6%) of the enrolled participants. Two STs were identified: ST3 (66.7%) and ST1 (33.3%). The positive rates of Blastocystis varied by geographical region, ranging from 1.2%–12.0%. ST3 was the predominant subtype in all centers except one, where only ST1 was isolated. Phylogenic analysis showed clustering based on ST, but no significant differences were found among the regions. There was no association between Blastocystis colonization and either age or sex of the participants. Conclusions The results of this multicenter study demonstrated colonization by Blastocystis, mainly ST3, in the gastrointestinal tracts of asymptomatic individuals in South Korea.

Sacrococcygeal teratoma is the most common congenital tumor in neonates, and is reported in approximately 1/35,000 to 1/40,000 live births. Oligodendroglioma is a rare central nervous system tumor that is usually found in the cerebral hemisphere of young and middle aged adults. When associated with a teratoma, it is mainly identified in ovarian teratoma in adolescents and adults. We describe a rare case of a preterm infant with oligodendroglioma in a mature sacrococcygeal teratoma. The male neonate was born at a gestational age of 30 weeks with a protruding mass in the sacrococcygeal region. Pelvic magnetic resonance imaging showed a sacrococcygeal teratoma of approximately 11 cm comprising fat components and skeletal structure, that extended from the anterior part of the sacrum to the abdominal cavity. Radical resection was performed at 36 days of age. Macroscopically, the resected intra-abdominal mass had the characteristics of a cystic lesion, and the intrapelvic mass was a predominantly solid mixed cystic-solid lesion. Histologically, this solid lesion in the intrapelvic mass was composed of mature glial tissue, which comprised as a proliferation of monotonous cells with small and round nuclei, surrounded by a perinuclear halo (“fried egg” appearance). Additionally, these cells were immunohistochemically positive for glial fibrillary acidic protein. These findings confirmed the diagnosis of oligodendroglioma in sacrococcygeal mature teratoma. After the treatment, no recurrence was observed during the follow-up period, and no additional intervention was required. However, the patient is undergoing treatment for voiding dysfunction caused by a neurogenic bladder.