BACKGROUND: The purpose of this study was to evaluate the usefulness and safety of the anterosuperior deltoid splitting approach for fixation of displaced proximal humeral fractures by analyzing the surgical outcomes. METHODS: Twenty-three patients who could be followed-up for at least 8 months after the treatment of displaced proximal humeral fractures through the anterosuperior deltoid splitting approach were enrolled. We evaluated the reduction of the fractures and surgery-related complications at the last follow-up using X-ray results and clinical outcomes comprising the University of California at Los Angeles (UCLA) scoring system and the Korean Shoulder Society (KSS) score. RESULTS: At the last follow-up of patients treated using the anterosuperior deltoid splitting approach for internal fixation of proximal humeral fractures, we found 22 cases (95.6%) of bone union, a mean UCLA score of 28.3 (range, 15 to 34) and a mean KSS score of 82.1 (range, 67 to 95). Various surgery-related complications were noted; a case of varus malunion after fracture displacement, a case of nonunion, a case of delayed union, two cases of impingement, and a case of partial axillary nerve injury, which recovered completely through the follow-up. CONCLUSIONS: Plate fixation using the anterosuperior deltoid splitting approach could be another reliable option for treating displaced proximal humeral fractures.
California ; Follow-Up Studies ; Humans ; Humerus ; Shoulder ; Shoulder Fractures*

No abstract available.
Emphysema* ; Tuberculosis*

Herpes zoster involving noncontiguous dual dermatomes is very rare in both immunocompetent and immunocompromised persons. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending whether one or both halves of the body are involved. A 22-year-old woman, who had been treated for acute leukemia, congestive heart failure and chronic disseminated candidiasis, was referred to our department for painful papulovesicular eruptions on the right side of the anterior chest and upper back for 2 days, and the left buttock for 1 day. Tzanck smear revealed multinucleated giant cells with intranuclear inclusion bodies. We report a rare case of zoster duplex bilateralis.
Buttocks ; Candidiasis ; Female ; Giant Cells ; Heart Failure ; Herpes Zoster* ; Humans ; Intranuclear Inclusion Bodies ; Leukemia ; Thorax ; Young Adult

Eosinophilia-myalgia syndrome(EMS) is a systemic illness that occurred as an epidemic by ingestion of over-the counter L-tryptophan preparation in the United States in October 1989. We report a Korean case of EMS not associated with the ingestion of either L-tryptophan or other nutritional supplements such as lysine and niacin.
Eating* ; Eosinophilia-Myalgia Syndrome* ; Lysine ; Niacin ; Tryptophan ; United States

Idiopathic atrophoderma of Pasini and Pierini(IAPP) is an uncommon condition of unknown etiology and typically affects persons in the second and third decades of life. IAPP consists of asymptomatic grey to brown depressed lesions with "cliff drop" borders, which are usually bilateral and located on the trunk. A 40-year-old woman visited our department because of unilateral atrophic lesions on the abdomen, right arm, and posterior aspect of right thigh for 20 years. Laboratory evaluations were normal and histologic examination revealed significantly decreased thickness in dermis. We report an unusual case of idiopathic atrophoderma of Pasini and Pierini presenting unilateral distribution.
Abdomen ; Adult ; Arm ; Dermis ; Female ; Humans ; Thigh

A traumatic dislocation of the sternoclavicular joint is a rare injury, and among them, anterior dislocation is more common than a posterior dislocation. Posterior dislocation is a potential risk by compressing the mediastinal structures, but an anterior dislocation has not been considered a risk. Traumatic sternoclavicular joint anterior dislocation associated with anterior angulation of a sternal fracture can develop mediastinal compression and have a risk in the same way as a posterior dislocation. This case report is about a traumatic sternoclavicular joint anterior dislocation with a sternal fracture accompanied by mediastinal compression that was treated surgically using a plate and showed relatively good clinical results. This rare case is reported along with a review of the relevant literature.

Background: The aim of this study was to introduce a novel technique to improve the ease of fixing of even small fragments of the coronoid process and report the clinical outcomes of this method. Methods: Forty-nine patients with ulnar coronoid process fractures fixed using the hooked Kirschner wire (K-wire) technique at our hospital from 2007 to 2019 were reviewed. Radiological features and fracture union were assessed using simple radiographs.Functional outcomes of the treated elbows were evaluated at the final follow-up visit using the Mayo Elbow Performance Score (MEPS). Results: All patients were examined at a mean follow-up of 17.7 months (range, 6–62 months). We observed bony union in patients at a mean of 10.9 weeks (range, 6–22 weeks). The mean flexion and extension ranges of the elbow were 132.0° (range, 106° –151°) and 4.5° (range, –20° to 30°), respectively. The mean pronation and supination ranges of the forearm were 81.1° (range, 60°–90°) and 88.3° (range, 60°–120°), respectively. The mean arc of the elbow was 127.4° (range, 78°–160°). All patients were evaluated using the MEPS at the final follow-up visit, with a mean score of 96.9 points (range, 80–100 points). One case of coronoid nonunion was observed and re-fixation was performed. One case of infection was observed and also treated with additional surgery. Three patients complained of ulnar nerve symptoms and 1 patient underwent surgical release for tardy ulnar nerve palsy. Conclusions Despite its limitations, the hooked K-wire technique was a useful method for even smaller coronoid process fractures. K-wires were also a useful temporary intraoperative fixation method and could provide permanent fixation.

Almost all colorectal carcinomas have been thought to develop from pre-existing adenomas. However, some colorectal carcinomas can arise directly from normal flat mucosa, and usually form infiltrative mass at the early stage. The carcinogenesis of this infiltrative carcinoma may be different from the well-known adenoma-carcinoma sequence, which usually forms a polypoid mass. The purpose of this study is to investigate the different expression of various oncogenes in polypoid carcinoma and infiltrative carcinoma. We performed immunohistochemical staining on p53, bcl-2, c-erbB-2 and MIB-1 in 29 polypoid carcinomas arised from adenomas, and 21 infiltrative carcinomas. The average tumor size of infiltrative carcinomas (5.5 cm) was larger than that of polypoid carcinomas (3.1 cm), and the polypoid carcinomas were differentiated more than the infiltrative carcinomas. The results of p53, bcl-2, c-erbB-2, and MIB-1 antisera immunoreactivity in the polypoid carcinoma were 79%, 17%, 21%, and 100%, and those in the infiltrative carcinoma were 71%, 29%, 29%, and 100%, respectively. However the diffuse positivities of p53 and MIB-1 antisera were slightly higher in the infiltraive carcinomas (62%, 76%) than in the polypoid carcinomas (55%, 41%) (p=0.63, 0.01). And the results of p53 and c-erbB-2 immunoreactivity in the adenomas were 52% and 17%, respectively, which is significantly lower than that in the polypoid carcinoma(p=0.03, 0.74). The immunoreactivty of bcl-2 in the adenoma was 72%, which was significantly higher than that in the polypoid carcinoma (17%) (p<0.01). In summary, we did not show the significant difference in expression of p53, bcl-2, c-erbB-2, and MIB-1 proteins between polypoid and infiltrative carcinomas. However, the tendency of infiltrative carcinomas having a more aggressive nature suggests another carcinogenetic mechanism is involved in the colorectal carcinogenesis.
Adenoma ; Carcinogenesis ; Colorectal Neoplasms* ; Immune Sera ; Ki-67 Antigen ; Mucous Membrane ; Oncogenes

BACKGROUND: With the advance of socioeconomy and medical science, the population of the aged has been significantly increased. Therefore it needs to be studied the fundamental epidemiologic survey of dermatologic disease in the elderly. OBJECTIVES: The purpose of this study is to evaluate the prevalence of common dermatoses in the elderly and to compare these to previous studies. METHOD: 1,916 out-patients over 65 years old who had visited the Department of Dermatology, University Hospital and Yongsan Hospital, College of Medicine, Chung Ang University from January, 1996 to December, 2001 were analyzed retrospectively. RESULTS: 1. The incidence of aged group over 65 years old to total number of out-patients(24,723) was 7.7%(1,916 cases). 2. The ratio of male to female was 1.06 : 1(986:930). 3. The frequent skin diseases were herpes zoster(12.0%), benign tumor(9.0%), pruritus(8.9%), onychomycosis/tinea pedis(7.7%), contact dermatitis(7.2%), seborrheic dermatitis(5.4%). 4. Eczema was the most common disease group which revealed 18.5%. The second most frequent group was viral infection(15.3%), followed by fungal infection(12.7%), tumor(12.0%), urticaria, drug eruption and erythema(9.4%), pruritus(8.9%), papulosquamous disease(2.8%) and bacterial infection(2.6%). 5. The most common disease in each disease group were as follows : contact dermatitis in eczema, herpes zoster in viral infection, onychomycosis and tinea pedis in fungal infection, urticaria in urticaria, drug eruption and erythema group, generalized pruritus in pruritus group, psoriasis in papulosquamous disease and folliculitis in bacterial infection, respectively. 6. Among 235 cases of skin tumor, 175 cases(74.5%) were benign and the remaining 60 cases(25.5%) were premalignant or malignant. The frequency of benign tumor was in order of seborrheic keratosis, epidermal cyst, skin tag and lipoma, respectively. In malignancy, there were basal cell carcinoma, squamous cell carcinoma and cutaneous metastatic carcinoma. CONCLUSION: Compared to previous studies, tumor and pruritus showed a increasing tendency but eczema a decreasing tendency.
Aged* ; Bacterial Infections ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatitis ; Dermatitis, Contact ; Dermatology ; Drug Eruptions ; Eczema ; Epidermal Cyst ; Erythema ; Female ; Folliculitis ; Herpes Zoster ; Humans ; Incidence ; Keratosis, Seborrheic ; Lipoma ; Male ; Onychomycosis ; Outpatients ; Prevalence ; Pruritus ; Psoriasis ; Retrospective Studies ; Skin Diseases* ; Skin* ; Tinea Pedis ; Urticaria

We evaluated the antibacterial, anti-inflammatory, and inhibitory effect of osteoclast differentiation of Brachypodium sylvaticum (BS) to find out the possibility of preventing periodontal disease. The inhibition of Porphyromonas gingivalis (P. gingivalis) growth by BS and the sustainability of the antibacterial activity was assessed. The production of pro-inflammatory cytokines from lipopolysaccharide (LPS)-induced RAW 264.7 cells were measured using enzyme-linked immunosorbent assays (ELISA), and the production of nitric oxide (NO) and cell viability were measured. Osteoclast differentiation was evaluated by Tartrate-resistant acid phosphatase (TRAP) staining, and TRAP activity. BS showed significant antibacterial activity and sustainable antibacterial activity in P. gingivalis. We also found out that the BS significantly decreased secretion of pro-inflammatory cytokines [tumor necrosis factor (TNF-α) and interleukin-6 (IL-6)] and NO production without cytotoxicity. Furthermore, BS inhibited the differentiation of bone marrow macrophages (BMMs) obtained from mouse bone marrow cells into osteoclasts without cytotoxicity. Taken together, BS can be a promising candidate for a preventive and improving agent of periodontal disease having antibacterial, anti-inflammatory, and inhibitory effects of osteoclast differentiation.