No abstract available.
Tibial Fractures*

BACKGROUND: Nodal marginal zone lymphoma (NMZL) is a rare B-cell neoplasm consisting of heterogeneous cellular components and residual B-cell follicles. Because of such histological features, it is difficult to diagnose NMZL by fine needle aspiration (FNA) cytology. We reviewed FNA cytology of NMZL to identify a cytological clue to avoid misdiagnosing NMZL. METHODS: Histological, cytological, and clinical findings of seven cases of NMZL were reviewed. RESULTS: Most cases showed nodular aggregates of lymphohistiocytes derived from the germinal center irrespective of histological pattern. The cellular components were heterogeneous and composed of mature small lymphocytes, intermediate and large lymphocytes, immunoblasts, tingible body macrophages, and follicular dendritic cells. Intermediate-sized neoplastic cells with a pale nucleus were observed but difficult to identify because of admixed non-neoplastic cells, which outnumbered neoplastic cells. Except for one case with a high proportion of intermediate-sized cells, the other six cases were initially diagnosed as reactive hyperplasia. A flow cytometric analysis was performed in two cases and failed to demonstrate a monoclonal B-cell population. CONCLUSIONS: The FNA showing a reactive hyperplasia-like smear pattern should be carefully observed by experienced cytopathologists to identify intermediate-sized neoplastic cells. Clinical information including the size of the lymph nodes is important to avoid a misdiagnosis.
B-Lymphocytes ; Biopsy, Fine-Needle ; Dendritic Cells, Follicular ; Diagnostic Errors ; Germinal Center ; Hyperplasia ; Lymph Nodes ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Macrophages

Recently, we experienced a case of myotonia dystrophy at Pediatric department of Yonsei Medical School. And we are presenting the case we experienced with reviewing the literatures.
Myotonia* ; Schools, Medical

Pseudoaneurysm is one of the undesirable complications of interventional cardiology procedures involving peripheral puncture site. Nowadays, it is not uncommon as a consequences of more complex interventional preocedures, larger catheters and prolonged anticoagulation treatment. Surgical repair has been mainstay of treatment for pesudoaneurysm. However, sucessful closures of pseudoaneurysms have been reported recently by using direct compression guided by color doppler ultrasound. We report a case of pseudoaneurysm in femoral artery, which was developed at the right inguinal puncture site in 38 year old male patient with unstabel angina who had received continuous intravenous infusion of heparin and had undergone coronary angiography treated successfully with direct compression guided by color doppler ultrasound.
Adult ; Aneurysm, False* ; Cardiology ; Catheters ; Coronary Angiography ; Femoral Artery* ; Heparin ; Humans ; Infusions, Intravenous ; Male ; Punctures ; Ultrasonography*

BACKGROUND: Korea is an endemic area of viral hepatitis B. In spite of the HBV vaccination program since 1983, the prevalence of HBV antigen had remained high, which was 3.9% in male, 2.7% in female in 1994. But there is no approved management guideline on isolated anti-HBc and the meaning of which is not clear except the evidence of past infection. Therefore, we tried to investigate the factors which influence the seroconversion of anti-HBs during follow-up period. METHODS: Medical records of 239 subject with isolated anti-HBc, who visited a health promotion center from 1995 to 1997 and who were retested at least once during the 1-3 years' follow-up period, were analyzed. RESULTS: The seroconversion rate of anti-HBs was 45.61%(109/239) on the follow-up test. The number of newly vaccinated or non-newly vaccinated subjects during the follow-up period was 156 and 72, respectively. The seroconversion rate of anti-HBs of each group were 57.69%(90/156) and 22.22% (16/72) respectively(p<0.01). The subjects without previous history of HBV vaccination was 103. Among them the seroconversion rate of anti-HBs of the newly vaccinated or the non newly vaccinated group were 59.70%(40/67) and 22.22% (8/36), respectively(p<0.01). Sex, age, BMI, smoking, previous history of HBV vaccination did not influence significantly on the seroconversion rate of anti-HBs among the subjects with isolated anti-HBc. CONCLUSIONS: The seroconversion rate in people with isolated anti-HBc was significantly higher in the newly vaccinated than the non-newly vaccinated regardless of the previous history of HBV vaccination in this study. In spite of the non-differentiation of an-amnestic response from primary antibody response, we can expect to benefit from HBV vaccination in those with isolated anti-HBc.59.70%(40/67) and 22.22% (8/36), respectively(p<0.01). Sex, age, BMI, smoking, previous history of HBV vaccination did not influence significantly on the seroconversion rate of anti-HBs among the subjects with isolated anti-HBc. CONCLUSIONS: The seroconversion rate in people with isolated anti-HBc was significantly higher in the newly vaccinated than the non-newly vaccinated regardless of the previous history of HBV vaccination in this study. In spite of the non-differentiation of an-amnestic response from primary antibody response, we can expect to benefit from HBV vaccination in those with isolated anti-HBc.
Antibody Formation ; Female ; Follow-Up Studies ; Health Promotion ; Hepatitis B ; Humans ; Korea ; Male ; Medical Records ; Prevalence ; Smoke ; Smoking ; Vaccination

BACKGROUND: Laryngeal mask airway (LMA) has recently been introduced as an alternative for the endotracheal tube. The respiratory mechanics and respiratory parameters during positive pressure ventilation (PPV) via the laryngeal mask airway (LMA) are not well known in children. So, we compared the effects of the endotracheal tube and the laryngeal mask airway on respiratory mechanics during the induction of general anesthesia in children. METHODS: We studied sixty ASA physical status I and II healthy children undergoing general anesthesia. Anesthesia was induced with sleep dose ketamine 1.0 mg/kg i.v., supplemented with propofol 2 mg/kg, Rocuronium 1.0 mg/kg i.v and maintained with 50% nitrous oxide and 2.0 Vol% sevoflurane. After inserting the laryngeal mask airway, its cuff was inflated using a balloon cuff gauge until the intracuff pressure reached approximately 60 cmH2O. Adequacy of ventilation was assessed by observing the end tidal carbon dioxide wave form, chest wall movement, and by stethoscope auscultation. Data were collected with lung mechanics recorders (Ventcheck, Novametrix Medical System, U.S.) at 5 and 10 minutes after intubation or LMA insertion. The data included Peak Inspiratory Pressure (PIP), Mean Airway Pressure (MAP), Peak End Expiratory Pressure (PEEP), Inspired Tidal Volume (VTins), Expired Tidal Volume (VTexp), Airway resistance (Raw), and Compliance (Cdyn). RESULTS: No significant difference was observed between the airway pressures, tidal volumes and gas leak fractions of the ETT and LMA groups. In terms of airway resistance and compliance, significant differences were observed between the two groups at 5 and 10 minutes. CONCLUSIONS: We conclude that the laryngeal mask airway is superior to endotracheal intubation in terms of airway resistance and compliance. The laryngeal mask airway offer an alternative for the children needing to avoid intubation under general anesthesia.
Airway Resistance ; Anesthesia ; Anesthesia, General* ; Auscultation ; Carbon Dioxide ; Child* ; Compliance ; Humans ; Intubation ; Intubation, Intratracheal ; Ketamine ; Laryngeal Masks ; Lung ; Mechanics ; Nitrous Oxide ; Positive-Pressure Respiration ; Propofol ; Respiratory Mechanics* ; Stethoscopes ; Thoracic Wall ; Tidal Volume ; Ventilation

In 2005, Kreidstein first proposed the term "Cutis pleonasmus," a Greek term meaning "redundancy," which refers to the excessive skin that remains after massive weight loss. Cutis pleonasmus is clearly distinguishable from other diseases showing increased laxity of the skin, such as pseudoxanthoma elasticum, congenital and acquired generalized cutis laxa. Although individuals who are severely overweight are few and bariatric surgeries are less common in Korea than in the West, the number of these patients is increasing due to changes to Western life styles. We report a case for a 24-year-old man who presented with generalized lax and loose skin after massive weight loss. He was diagnosed with cutis pleonasmus based on the history of great weight loss, characteristic clinical features and normal histological findings. To the best of our knowledge, this is the first report of cutis pleonasmus in Korea.
Bariatric Surgery ; Cutis Laxa ; Humans ; Korea ; Life Style ; Overweight ; Pseudoxanthoma Elasticum ; Skin ; Weight Loss ; Young Adult

The permanent impairment evaluation for children in developmental stage is very difficult and it is even impossible in some cases. The impairment evaluation for developing children has not yet been included in the guideline of the American Medical Association. Due to frequent medical and social demands in Korea, we developed an impairment evaluation guideline for motor impairment, intellectual disability/mental retardation, developmental speech-language disorder and epilepsy caused by pediatric cerebral injuries, or cerebral lesions other than the developmental disorders such as autism. With the help of various literature and foreign institutions, we developed our in order to develop a scientific guideline for pediatric impairment that is suited to Korean cultural background and social condition.
Brain/physiopathology ; Brain Diseases/*complications ; Brain Injuries/complications ; Child ; Developmental Disabilities/classification/*diagnosis/etiology ; *Disability Evaluation ; *Disabled Children ; Humans ; Korea ; Language Development Disorders/classification/diagnosis/etiology ; Mental Disorders/classification/diagnosis/etiology ; Program Development ; Seizures/classification/diagnosis/etiology ; Severity of Illness Index

We carried out the Schirmer test to measure objectively the amount of lacrimation among 51 clinically diagnosed parkinsonian patients (33 men and 18 women aged 50 to 79 years, mean 64) and 75 age-matched controls (42 men and 33 women aged 50 to 76, mean 62). Whatman No. 2 paper, prepared in precut strips 5mm by 35mm, was placed in the cul-de-sac for five minutes, after which the wetted length of the strip was studied. It was noted that the lacrimation amount decreased in patients with Parkinson's disease compared with controls: the average amount of lacrimation was 3.4 +/- 2.3mm in the former group and 8.1 +/- 6.5mm in the latter group (p < 0.01). We believe that the decrease in the amount of lacrimation is associated with emotional disturbance and autonomic dysfunction, and presume that the lacrimation may be under the control of the basal ganglia which has a connection with the superior salivatory nucleus downward and the limbic system upward.
Aged ; Autonomic Nervous System/physiopathology ; Female ; Human ; Limbic System/physiopathology ; Male ; Middle Age ; Parkinson Disease/*physiopathology ; Tears/*secretion

Background: Various materials, commonly called fillers, have been developed and are now used for cosmetic and reconstruction purposes. Indiscriminate injections of illegal and unknown substances have various side effects, among which foreign body granulomas are particularly difficult to treat. Surgical resection can be considered for small and well-defined foreign body granulomas, but complete resection is often impossible for wide facial granulomas, and postoperative deformities may occur. Therefore, this study presents cases where foreign bodies were evaluated using imaging studies and removed through minimally invasive procedures depending on their characteristics. Methods: Thirty-five patients with chronic granulomas after illegal filler injections treated from 2012 to 2019 were enrolled. Clinically, these granulomas were classified into cystic and infiltrating groups according to the imaging study patterns. Patients in the cystic group underwent puncture and drainage, and those in the infiltrating group were first treated with intralesional laser treatment and then suctioned. If the results were insufficient, surgical removal combined with a lifting procedure was performed. Results: All 35 patients were women, and their average age was 51 years. Surgery was successful in almost all cases, but four cases of insufficient removal and contour deformity were encountered during follow-up. Two patients underwent reoperation and two patients improved naturally. Conclusions In this study, we classified the characteristics of granulomas using preoperative imaging studies. Aesthetically favorable results were obtained using puncture and drainage and tumescent suction, along with, if necessary, surgical removal accompanied by a lifting procedure when removing facial foreign body granulomas.