No abstract available.
Gelatin Sponge, Absorbable* ; Hemorrhage* ; Thrombin*

PURPOSE: Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament(ACL) injury in MR image. MATERIAL AND METHODS: The knee MR images of 47 patients with ACL injury(complete; 24, partial; 23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament(PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. RESULTS: The means( +/- 2standard errors) of anterior translocation were different significantly in statistical analysis(p<0.001, student t-test) between injury group(7.51 +/- 1.16mm) and normal group(-0.56 +/- 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically b. etween injury group(0.23 +/- 0.02) and normal group(0.17 +/- 0.01)(p<0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear(66%), thirteen lateral meniscus tear(28%), ten medial collateral ligament injury(28%), one PCL injury (2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients {43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients(19%) and avulsion fractures of anterior tibial spine in four patients(9%). CONCLUSION: The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and meniscus injuries) are considered to be helpful in the diagnosis of ACL injury on Knee MR images, when the findings of anterior cruciate ligament itself are not confirmative.
Anterior Cruciate Ligament* ; Arthroscopy ; Bone Marrow ; Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity ; Spine ; Tibia

PURPOSE: Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament(ACL) injury in MR image. MATERIAL AND METHODS: The knee MR images of 47 patients with ACL injury(complete; 24, partial; 23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament(PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. RESULTS: The means( +/- 2standard errors) of anterior translocation were different significantly in statistical analysis(p<0.001, student t-test) between injury group(7.51 +/- 1.16mm) and normal group(-0.56 +/- 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically b. etween injury group(0.23 +/- 0.02) and normal group(0.17 +/- 0.01)(p<0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear(66%), thirteen lateral meniscus tear(28%), ten medial collateral ligament injury(28%), one PCL injury (2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients {43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients(19%) and avulsion fractures of anterior tibial spine in four patients(9%). CONCLUSION: The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and meniscus injuries) are considered to be helpful in the diagnosis of ACL injury on Knee MR images, when the findings of anterior cruciate ligament itself are not confirmative.
Anterior Cruciate Ligament* ; Arthroscopy ; Bone Marrow ; Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity ; Spine ; Tibia

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) strategy is proposed to reduce the ventilator-induced lung injury in acute respiratory distress syndrome (ARDS). As ECMO use has increased, a number of studies on prognostic factors have been published. Age is estimated to be an important prognostic factor. However, clinical evidences about ECMO use in elderly patients are limited. Therefore, we investigated clinical courses and outcomes of ECMO in elderly patients with ARDS. METHODS: We reviewed medical records of patients with severe ARDS who required ECMO support. Study patients were classified into an elderly group (> or = 65 years) and a non-elderly group (< 65 years). Baseline characteristics, ECMO related outcomes and associated factors were retrospectively analyzed according to group. RESULTS: From February 2011 to June 2013, a total of 31 patients with severe ARDS were treated with ECMO. Overall, 14 (45.2%) were weaned from ECMO, 9 (29.0%) survived to the general ward and 7 (22.6%) survived to discharge. Among the 18 elderly group patients, 7 (38.9%) were weaned from ECMO, 4 (22.2%) were survived to the general ward and 2 (11.1%) were survived to discharge. Overall intensive care unit survival was inversely correlated with concomitant acute kidney injury or septic shock. CONCLUSIONS: In this study, ECMO outcome was poor in severe ARDS patients aged over 65 years. Therefore, the routine use of ECMO in elderly patients with severe ARDS is not warranted except in highly selective cases.
Acute Kidney Injury ; Aged* ; Extracorporeal Membrane Oxygenation ; Humans ; Intensive Care Units ; Medical Records ; Patients' Rooms ; Respiratory Distress Syndrome, Adult* ; Retrospective Studies ; Shock, Septic ; Ventilator-Induced Lung Injury

No abstract available.
Cochlear Implants*

Merkel cell carcinoma is a rare, aggressive skin cancer that occurs most frequently in the elderly on sun-exposed areas. However, any possible cutaneous or mucosal sites may also be involved. It usually presents as a rapidly- growing, painless, single red or purple colored cutaneous papule, nodule or indurated plaque that may elude diagnosis until histopathologic examination. We report a case of an 83-year old female patient who presented with a 3 x 3.5 cm sized, skin-colored, painful nodule on the left mandibular angle area. A new red nodule had combined on the original lesion after 6 months, and showed unusual clinical manifestation. Microscopically, the tumor cells were uniform with round to oval-shaped nuclei and scanty cytoplasm, and they showed a trabecular arrangement. In immunohistochemical studies, the patient was reactive to cytokeratin-20, and focally reactive to NSE and synaptophysin.
Aged ; Aged, 80 and over ; Carcinoma, Merkel Cell* ; Cytoplasm ; Diagnosis ; Female ; Humans ; Keratin-20 ; Skin Neoplasms ; Synaptophysin

BACKGROUND: Alopecia areata (AA) is an autoimmune condition of the hair follicle, resulting in bald patches. The details of the pathogenesis of AA still remain unclear. However, several recent studies have indicated that AA is an organ-specific autoimmune disease in which T cells (especially CD8+T cells), as well as certain cytokines (especially Th1 cytokines, IL-1, IFN-gamma, and TNF-alpha) may play an important role in its development. OBJECTIVE: The purpose of this study was to characterize the cytokine response in the peripheral blood of patients with AA, before and after treatment. METHODS: Twenty one active AA patients and 10 healthy people were evaluated in this study. The levels of 3 cytokines, including IFN-gamma, IL-10, and IL-16, in all subjects were measured at the first visit and 3 months after treatment. RESULTS: The levels of IFN-gamma, IL-10, and IL-16 in the AA group were significantly elevated (p<0.05) compared to the normal control group. The level of IFN-gamma showed an excellent response to treatment (hair regrowth>75%), and was decreased in comparision to the level before treatment (p=0.003). There was no difference in the cytokine levels after PUVA, DPCP, or a combination therapy of PUVA and DPCP (p>0.05). CONCLUSION: The results suggest the involvement of IFN-gamma in the AA process. Also, IFN-gamma could be a potential marker for treatment. Even though different treatments have different mechanisms, IFN-gamma is considered to be a common pathway for alopecia areata treatment.
Alopecia Areata* ; Alopecia* ; Autoimmune Diseases ; Cytokines ; Hair Follicle ; Humans ; Interleukin-1 ; Interleukin-10* ; Interleukin-16* ; T-Lymphocytes

BACKGROUND: Mesenchymal stem cells can be expanded rapidly in vitro and differentiated into multiple mesodermal cell types. This study was planned to isolate human adipose tissue stromal cells (hATSCs) from human liposuction tissues and to investigate the changes of tactile threshold after hATSC transplantation in animal neuropathic pain models. METHODS: hATSCs were grown under control conditions in alpha-MEM/10% FBS. To prepare neuropathic pain model rats, thirty male Sprague-Dawley rats that had the average body weight of 208 +/- 5 g, had an experimental nerve injury by cutting or clamping of sural and tibial nerves. The tactile threshold was measured by von Frey hair filament at preinjury and postoperative day (POD) 1, 2, 3, 7, 14. Transplantation of hATSCs was performed after measurement of tactile threshold at POD3. RESULTS: hATSCs grew as a monolayer of large, flat, and spindle-shaped cells. The tactile threshold after spared nerve injury was significantly decreased since one day after cutting or clamping of nerves (P < 0.01). The percent changes of a tactile threshold in clamping and hATSC group were decreased to 59.8 +/- 7.1% (POD7) and 52.6 +/- 5.1% (POD14) (P < 0.05). CONCLUSIONS: This results was suggested that hATSCs could be isolated from human adipose tissue easily. Althogh it needs more long-term investigation hATSCs might be used as a method of therapy for neuropathic pain.
Adipose Tissue ; Animals ; Body Weight ; Constriction ; Hair ; Humans ; Lipectomy ; Male ; Mesenchymal Stromal Cells ; Mesoderm ; Neuralgia* ; Rats* ; Rats, Sprague-Dawley ; Stem Cells ; Stromal Cells ; Tibial Nerve

Basal cell carcinoma (BCC) in the skin is the most common malignancy worldwide. Surgery is still the golden standard treatment for BCCs, but it may be intensive and sometimes excessively destructive. Imiquimod is a member of novel class of immune response modifiers which stimulate or enhance both the innate immune system and cell-mediated immune response and approved by FDA for treating anogenital wart. A 73-year-old male patient was presented with 8x10cm sized erythematous scaly, peripheral ridging patch with central black colored crust on the back. Histopathological finding showed masses of various shapes and sizes composed of basalioma cells. He refused surgery treatment, so we tried 5% imiquimod cream (AldaraTM, 3M) topically three times weekly for the duration of 7 months. Although lesions had incompletely resolved, clinically and histopathologically improvement was observed. Herein we report a case of basal cell carcinoma which responded to imiquimod.
Aged ; Carcinoma, Basal Cell* ; Humans ; Immune System ; Male ; Skin ; Warts

BACKGROUND: Arginine vasopressin has been used by prophylactic treatment of vasodilatory shock during coronary artery bypass graft (CABG). Vasopressin may be a cause of spasm in graft artery during CABG. We evaluated the effect of propofol on vasopressin-induced contraction in human gastroepiploic artery (GEA). METHODS: Human GEA were obtained from 35 patients (43-74 yr), undergoing subtotal gastrectomy. Vasopressin-induced a concentration contractions (10(-9) to 10(-6) M) were measured after exposed to without propofol, propofol 10(-5), 10(-4), 10(-3) M. After endothelium denuding vasopressin-induced a concentration contractions were measured with or without propofol 10(-3) M in calcium free solution. In the denuded vascular rings, with or without pretreatment of glibenclamide (10(-5) M), nicorandil (10(-5) M), or diltiazem (10(-5) M) were exposed to with or without propofol 10(-3) M, and vasopressin-induced concentration contractions were measured. RESULTS: Vasopressin-induced concentration contraction on human GEA was independent of functional endothelium. Propofol (10(-4), 10(-3) M) attenuated the vasopressin-induced contraction in the human GEA. Diltiazem attenuated the vasopressin-induced contraction in the human GEA. ATP-sensitive potassium channel does not affect the inhibition effect of propofol on vasopressin-induced contraction CONCLUSIONS: Usual anesthetic dose of propofol does not inhibit vasopressin-induced contraction on human GEA. High dose (>10(-4) M) propofol attenuated vasopresssi-induced contraction on GEA.
Arginine ; Arginine Vasopressin ; Arteries ; Calcium ; Contracts ; Coronary Artery Bypass ; Diltiazem ; Endothelium ; Gastrectomy ; Gastroepiploic Artery ; Glyburide ; Humans ; Nicorandil ; Potassium Channels ; Propofol ; Shock ; Spasm ; Transplants ; Vasopressins