Localized pigmented villonodular synovitis is a monoarticular proliferative condition that may affect any joint but is frequently found in the knee. The locaiized form was less frequent than the diffuse one. The estimated frequency of localized pigmented villonodular synovitis among patients performed an arthroscopic procedure was known one case lor each 2,500 cases. Previous reports pointed that the lower recurrence rate after the arthroscopic excision for localized form. We also experienced a case of localized pigmented viilonodular synovitis located at the posterior compartment of the knee, so we report this case with review of literatures.
Humans ; Joints ; Knee* ; Recurrence ; Synovitis ; Synovitis, Pigmented Villonodular*

Anaphylactic deaths are frequently observed at autopsies. Since death associated with medical practice has become social concern, the identification of anaphylactic shock is an important part of forensic medicine. However, autopsy findings of anaphylactic shock are usually non-specific; therefore, the diagnosis of anaphylactic shock must be inferred from collecting data on the past history of the deceased, circumstances of death, and negative autopsy findings. The analysis of serum mast cell tryptase level is a well-known, useful ancillary test for the diagnosis of anaphylactic shock, but is not widely used in daily practice in Korea. We recently encountered 2 autopsy cases of anaphylactic shock and confirmed that analysis of serum mast cell tryptase level was useful for the diagnosis of anaphylactic shock. In this report, we present these 2 autopsy cases of anaphylactic shock, with literature review of the usefulness and limitations of serum mast cell tryptase analysis.
Anaphylaxis ; Autopsy ; Forensic Medicine ; Korea ; Mast Cells ; Tryptases

Background: The purpose of this study was to assess the reliability and validity of the 3-item version of the Work Engagement Scale (WES-3), which is based on the Job DemandsResources (JD-R) model and was used in the 5 th Korean Working Conditions Survey (KWCS). Methods: This study used data from the 5th KWCS (n = 50,205), which was conducted in 2017 with a sample of the Korean working population. The survey gathered comprehensive information on working conditions to define workforce changes and the quality of work and life. The reliability and internal consistency of the WES-3 were assessed using the corrected item-total correlation and Cronbach's alpha coefficient. Confirmatory factor analysis (CFA) was used to test the construct validity of work engagement. The convergent validity was assessed using the correlation with the WHO-5 well-being index. Correlations between work engagement and JD-R factors were also calculated. Results: The Cronbach's alpha for work engagement was 0.776, indicating acceptable internal consistency. The model comprising 3 work engagement and 2 burnout items showed an excellent fit (χ2 : 382.05, Tucker-Lewis index: 0.984, comparative fit index: 0.994, root mean square error of approximation: 0.043). The convergent validity was significant (correlation coefficient: 0.42). Correlations with burnout and job demands were negligible, whereas correlations with job resources and job satisfaction were weakly positive. Conclusions The results of our study confirm that the WES-3 has acceptable reliability and validity.

Background: The purpose of this study was to assess the reliability and validity of the 3-item version of the Work Engagement Scale (WES-3), which is based on the Job DemandsResources (JD-R) model and was used in the 5 th Korean Working Conditions Survey (KWCS). Methods: This study used data from the 5th KWCS (n = 50,205), which was conducted in 2017 with a sample of the Korean working population. The survey gathered comprehensive information on working conditions to define workforce changes and the quality of work and life. The reliability and internal consistency of the WES-3 were assessed using the corrected item-total correlation and Cronbach's alpha coefficient. Confirmatory factor analysis (CFA) was used to test the construct validity of work engagement. The convergent validity was assessed using the correlation with the WHO-5 well-being index. Correlations between work engagement and JD-R factors were also calculated. Results: The Cronbach's alpha for work engagement was 0.776, indicating acceptable internal consistency. The model comprising 3 work engagement and 2 burnout items showed an excellent fit (χ2 : 382.05, Tucker-Lewis index: 0.984, comparative fit index: 0.994, root mean square error of approximation: 0.043). The convergent validity was significant (correlation coefficient: 0.42). Correlations with burnout and job demands were negligible, whereas correlations with job resources and job satisfaction were weakly positive. Conclusions The results of our study confirm that the WES-3 has acceptable reliability and validity.

Acantholytic dyskeratosis is a regular histologic feature in Darier's disease, transient acantholytic dermatosis and warty dyskeratoma. It is also occasionally observed as an incidental histological finding in linear epidermal nevus. We report a case of acantholytic dyskeratotic epidermal nevus in an 11-month-old boy. The patient showed unilateral, brown colored verrucous plaque on the right shin. Histological finding showed hyperkeratosis, irregular acanthosis & focal acantholytic dyskeratosis.

BACKGROUND: Reperfusion of ischemic myocardium has been postulated to result in a specific oxygen radical mediated tissue injury. Iron may liberate during ischemia and we hypothesized that administration of the iron chelator, deferoxamine during ischemia would result in improved recovery after postischemic reperfusion. PURPOSE: To test whether iron-catalyzed processes contribute to myocardial necrosis during ischemia and reperfusion, deferoxamine was administered to block iron catalyzed hydroxyl radical formation in rabbits. METHODS: Eleven rabbits were divided into two groups: control group (n=5) and deferoxamine pretreatment group (n=6). the left circumflex coronay artery was ligated for 30 minutes and reperfused for 180 minutes. Area at risk (AR) was measured by non-stained area with ethylene blue injection into left atrium after left circumflex coronary artery ligation. Infarct size was measured by weighing after tripheyltetrazolium chloride staining. Heart rate was measured using electrocardiographic recording and systemic blood pressure was monitored by pressure transducer connected to the catheter in the left ventricle. RESULTS: 1. There was no significant difference of heart rate and blood pressure in deferoxamine pretreatment group compared with control group. 2. There was significant decrease of serum iron concentration after continuous infusion of deferoxamine compared with serum iron concentration before ligation of coronary artery (P<0.05). 3. There was no significant difference of area at risk between control and deferoxamine pretreatment group. 4. Area at necrosis to area at risk was significantly reduced in deferoxamine pretreatment group compared with control group (P<0.05) The results suggest that deferoxamine infusion prior to coronary artery occlusion has a significant benefit in reducing infarct size in this model.
Arteries ; Blood Pressure ; Catheters ; Coronary Vessels ; Deferoxamine* ; Electrocardiography ; Heart Atria ; Heart Rate ; Heart Ventricles ; Hydroxyl Radical ; Iron ; Ischemia ; Ligation ; Myocardial Infarction* ; Myocardium ; Necrosis ; Oxygen ; Rabbits ; Reperfusion ; Transducers, Pressure

PURPOSE: One of the most difficult problems in the care of children with nephrotic syndrome remains the occurrence of relapses, despite initial response to steroids. Constantinescu reported that rapidity of initial response to steroid therapy could predict fewer relapses in the first year. So we evaluated the changes in serum lipid abnormalities in children with corticosensitive nephrotic syndrome before steroid treatment and the correlation between serum lipid levels and renal function, days to remission. METHODS: We analyzed the medical records of children who were managed by us between October 1994 and August 2000. In 33 patients with corticosensitive nephrotic syndrome, we evaluated the correlation between serum lipid levels and renal function [Creatinine clearance(Ccr)] and proteinuria before steroid treatment, and days to remission defined as the third day when the patient`s urine becomes protein free. RESULTS: There were 21 males and 12 females. Median age at presentation was 6.4 years (range: 1.8-17.3 years). Median days to remission were 15.4 days (range 4-42 days) on Prednisolone 60mg/m2 daily. The increased levels of triglyceride, total cholesterol, LDL cholesterol, apolipoprotein B, total cholesterol/HDL cholesterol, Lipoprotein(a) were observed. But the level of HDL cholesterol was not increased. Serum albumin was decreased and proteinuria was increased before steroid treatment. But Ccr was not decreased. There were negative correlation between serum albumin and total cholesterol (r = -0.5157, P<0.005), LDL cholesterol (r = -0.5543, P<0.005), total cholesterol/HDL cholesterol (r = -0.4506, P<0.01), lipoprotein(a) (r = -0.4570, P<0.025), apolipoprotein B (r = -0.5297, P<0.025), apolipoprotein B/apolipoprotein A1 (r = -0.5851, P<0.01), apolipoprotein B/HDL cholesterol (r = -0.4961, P<0.05) before steroid treatment. There was no correlation between proteinuria and serum lipid profiles. Also Ccr and serum lipid profiles were not correlated. There was positive correlation between days to remission and HDL cholesterol (r = +0.4511, P<0.05), apolipoprotein B (r = +0.5190, P<0.05), apolipoprotein B/HDL cholesterol (r = +0.7169, P<0.005). CONCLUSIONS: This results reveal that HDL cholesterol, apolipoprotein B and apolipoprotein B/HDL cholesterol can be used as a predictive factor in corticosensitive nephrotic syndrome. We could not determine the significant level of these lipids for insufficient patients number, but these level may predict future relapses of corticosensitive nephrotic syndrome patients and thus may allow to better management and treatment protocols. More data and long term follow up studies should be needed.
Apolipoproteins ; Child ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Female ; Follow-Up Studies ; Humans ; Hyperlipidemias* ; Lipoprotein(a) ; Male ; Medical Records ; Nephrotic Syndrome* ; Prednisolone ; Proteinuria ; Recurrence* ; Serum Albumin ; Steroids ; Triglycerides

Erythema elevatum diutinum(EED) is a rare chronic skin disease characterized by red, purple, and yellowish papules, plaques, and nodules that are usually distributed acrally and symmetrically over extensor surface. It is characterized histologically by a leukocytoclastic vasculitis. Although no treatment has shown a complete response, dapsone is reported to be effective to EED. We report a rare severe case of EED with good response to dapsone treatment.
Dapsone ; Erythema* ; Skin Diseases ; Vasculitis

PURPOSE: This retrospective study was designed to evaluate the treatment results of chronic Achilles tendon rupture by Lindholm method. MATERIALS AND METHODS:Between 2002 and 2006, we performed the reconstruction of the Achilles tendon by using of the gatrocnemius-sloeus fascia known as Lindholm method. Ten cases of ten patients were enrolled in this study (8 men and 2 women). The mean age of the patients at the time of operation was 49 years (range, 32~66 years). The mean follow-up duration was 15.2 months (range, 12~19 months). The retrospective review of the clinical history, physical examination, the American Orthopedic Foot and Ankle Society (AOFAS) score were conducted. RESULTS:The mean AOFAS score before surgery was 74.10+/-2.56 and that of the latest follow-up was 90.60+/-5.72. The excellent results were six and good results were four patients. Eight patients were normal triceps power and the others were good. The average of heel to floor distance was 4.5 mm less in the operated legs than the contralateral ones in each patient, but there was no significant difference (p>005). The average of calf muscle circumference in the mid-leg was 7.5 mm less in the operated legs than the contralateral ones and there was significant difference (p<0.05). The active range of motion of the ankles, mean plantarflexion was 40 degrees and dorsiflexion was 16.8 degrees in operated side. The contralateral side was 43 degrees in plantarflexion and 19 degrees in dorsiflexion. No case showed rerupture of the reconstructed Achilles tendon. One patient had the superficial wound infection which was treated successfully by antibiotic therapy. CONCLUSION: It was suggested that the overall results of Lindholm method for the chronic Achilles tendon rupture indicated satisfactory outcomes
Achilles Tendon ; Animals ; Ankle ; Fascia ; Floors and Floorcoverings ; Follow-Up Studies ; Foot ; Heel ; Humans ; Leg ; Male ; Muscles ; Orthopedics ; Physical Examination ; Range of Motion, Articular ; Retrospective Studies ; Rupture ; Wound Infection

PURPOSES: The causes of altered mental status (AMS) are varied. Trauma accounts for 6.5%-36.3% of all AMS cases, and the mortality in these instances ranges from 20~80.5%. Multiple injury severity scoring systems exist to assist in the prognosing of trauma patients. We investigated the degree of correlation between injury severity scoring systems and prognoses of patients with AMS due to trauma. METHODS: We reviewed the medical records of 188 patients admitted to the emergency department of Konyang University Hospital who had trauma with AMS. We investigated the clinical characteristics of these patients and evaluated the usefulness of four injury severity scoring systems: revised trauma score (RTS), injury severity score (ISS), new injury severity score (NISS), and trauma and injury severity score (TRISS). RESULTS: The average scores of ISS and NISS were higher and RTS and TRISS were lower in the non-survivor group than in the survivor group (p<0.01). The area under the curve (AUC) for the receiver operating characteristic (ROC) curve was 0.725 for ISS and 0.733 for NISS, but these scoring systems had only a fair predictive ability. Hosmer-Lemeshow statistics showed no predictive ability differences for death between the four scoring systems. The predictive ability of all injury severity scoring systems to identify survivors was high (88.1~94.0%). In contrast, their predictive ability to identify non-survivors was low (29.6%~63.0%). CONCLUSIONS: In the use of RTS, ISS, NISS, and TRISS for evaluating trauma patients with AMS, none of the four systems exhibited any distinguishing predictive features. All failed to reliably predict non-survivors, but all showed good predictive value for identifying survivors.
Emergency Service, Hospital ; Humans ; Injury Severity Score ; Medical Records ; Mortality ; Multiple Trauma ; Prognosis ; ROC Curve ; Survivors