There has been considerable controversy in the treatment of acute grade 3 injuries of acromioclavicular joint. Neviaser reported that the possibility of a latent degenerative arthritis occurring in the acromioclavicular joint as the result of passing Kirschner wire through the joint was more theoretical than real and any changes that may take place in the acromioclavicular joint were the result of trauma. The acromioclavicular joint and the articular disc were not disturbed at the time of operation in Neviaser technique, but we excised the articular disc that were torn for the purpose of preventing acromioclavicular joint from degenerative arthritis. We had treated 26 cases of grade 3 injuries of acromioclavicular joint with modified Neviaser technique from June 1990 to May 1994 at the Pohang St. Mary’s Hospital. The results were as follows. 1. The clinical results by Weitzman were consisted of 18 cases(69%) of excellent, 6 cases(23%) of good, 2 cases(8%) of fair and 0 case(0%) of poor. 2. Loss of reduction was 1.6mm by stress views of final reviews and didn’t affect to functional result. 3. There were no cases of redislocation of acromioclavicular joint after removal of Kirschner wires. 4. There were no cases of degenerative arthritis of acromioclavicular joint in final review. There result suggest that excision of the articular disc that were torn may be helpful in preventing acromioclavicular joint from degenerative arthritis.
Acromioclavicular Joint ; Bone Wires ; Gyeongsangbuk-do ; Joints ; Osteoarthritis

Glaucoma cases undoubtedly represent one of the biggest ophthalmic problems in the field of public health. We analysed statistically 456 cases of the glaucoma patients among 35150 outpatients who visited to our eye department from Jan. 1982 to Dec. 1986. Diagnosis was performed by intraocular pressure, visual acuity, visual field, fundus and gonioscopic examination. The prevalence of the galucoma was 1.3% which was similar as other reports. The following results were obtained. 1. Among the 456 cases including 218 male and 238 female patients, there was no significant sexual difference statistically. 2. The age group over 40 years old occupied 65.9%. 3. The age group 4th and 6th decade in male and 6th and 7th decade in female occupied higher prevalence rate. 4. Open angle glaucoma has the highest prevalence rate. 5. Visual acuity was not significantly correlated to the latency. 6. Intraocular pressure appeared not to have significant correlation to the latency. 7. There was no significant difference in left and right eye. 8. There was significant correlation between the visual acuity and the intraocular pressure.
Adult ; Diagnosis ; Female ; Glaucoma* ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Male ; Outpatients* ; Prevalence ; Public Health ; Visual Acuity ; Visual Fields

PURPOSE: Hyperlipidemia and diabetes mellitus are common metabolic disorders associated with transplantation and also are risk factors of cardiovascular disease which is leading cause of patient death in kidney transplant recipients. We compared blood lipid and glucose levels of patients receiving tacrolimus (Tac) with those of patients receiving cyclosporine (CyA). METHODS: Patients were grouped as Tac (n=124) or CyA (n=77). Minimal follow up duration was 18 months. Both groups have no difference in age, sex, HLA match, numbers of transplantation and proportion of the patients with pretransplant hypercholesterolemia (>220 mg/dL) or diabetes. Prevalence of hypercholesterolemia and diabetes in Tac and CyA groups were compared at posttransplant 1, 3, 6, and 12 months. RESULTS: Prevalence of diabetes in CyA versus Tac group were 18.9 vs. 13.8% (P=0.348), 8.6% vs. 18.8% (P=0.060), 5.9% vs. 18.6% (P=0.016), and 10.4% vs. 21.1% (P=0.067) at 1, 3, 6 and 12 months after transplantation respectively. Prevalence of hypercholesterolemia in CyA versus Tac group were 52.5% vs. 16.9% (P=0.000), 37.7% vs. 8.3% (P=0.000), 30.3% vs. 7.4% (P= 0.000) and 22.6% vs. 8.3% (P=0.001) at 1, 3, 6, and 12 months after transplantation. CONCLUSION: CyA group was more prone to develop hypercholesterolemia than Tac group, whereas incidence of diabetes in Tac group was not different from CyA group. In terms of cardiovascular risk, there was no significant difference between CyA treated group and Tac treated group in renal allograft recipients.
Allografts* ; Cardiovascular Diseases ; Cyclosporine* ; Diabetes Mellitus ; Follow-Up Studies ; Glucose ; Humans ; Hypercholesterolemia ; Hyperlipidemias ; Incidence ; Kidney ; Prevalence ; Risk Factors ; Tacrolimus* ; Transplantation

Kimura's disease is a rare chronic inflammatory and proliferative condition of unknown etiology. It has been thought to be a part of large spectrum of the entity known as angiolymphoid hyperplasia with eosinophilia (ALHE). However, recently the difference is emphasized between the two entities by some authors. It usually presents subcutaneous or dermal mass in the head and neck region. This condition can be mistaken for a malignant tumor. It is defined pathologically as hyperplastic lymphoid follicles, eosinophilic infiltration and vascular proliferation. Authors have experienced three cases of Kimura's disease occurring in the submandibular, axillary and inguinal regions since 1993. There were two males and one female. Two patients presented peripheral eosinophilia. All patients underwent surgical excision. Two patients were managed with oral prednisone postoperatively.
Angiolymphoid Hyperplasia with Eosinophilia ; Eosinophilia ; Eosinophils ; Female ; Head ; Humans ; Male ; Neck ; Prednisone

PURPOSE: The aims of this project were to increase organ donation by developing potential brain dead donor actively and to provide basic data to settle up independent Organ Procurement Organization (OPO) in Korea. METHODS: Hospital based Organ Procurement Organization (HOPO) of Keimyung university worked as a regional OPO and all the reported potential brain dead patient were treated by OPO team during May through October, 2007. Every reported and confirmed brain dead patient was evaluated for their eligibility of organ donation and these organs were allocated by Korean Network for Organ Sharing (KONOS). In order to increase the development of organ donation, campaign was done for public and medical personnels. To estimate the capacity of brain death donor pool, medical records of the dead patients with brain injury were evaluated. Accommodations and educations to the care-giver to the potential donor, neurosurgeon, neurologist and emergency department physicians were also done. For standardization of potential donor care, frame a clinical pathway of the care of the potential donor from the data of computerized records. The cash flow of whole process from developing potential donor to final procurement of organs were calculated to provide minimum expenses for operating Independent OPO in our environment. RESULTS: Total 33 solid organs were procured from 11 brain dead donor during the experimental period. Twelve more organs were possible to donate but not procured because there were no matched recipient at that time. The reported number of potential donor was increased 2.5 times, compare to the same period of previous year (19 from 5 hospital in 2006 but 47 from 14 collaborating hospitals in 2007). Among 47 notified potential donor, only 11 were succeeded to procure. The reasons of failure for procurement in 36 patients were no familial consent in 12, poor patient condition to donate in 9, not in brain death criteria in 15. These results mean that we have at least 21 more potential donors if we can get familial consent and use marginal donor, and early notification. Mean medical expenses were 3 million won for individual expense beside insurance coverage and 5 million won for management expense of donor care from the detection to organ procurement. CONCLUSION: Our results showed the number of the potential donor and actual organ donation can be increased by continued active relationship with regional hospital and adequate care of the donor. The big gap between the profit from our donor care and calculated donor management expenses of IOPO can be progressively covered by increasing number of brain dead donor, increasing procurement rate and increasing organ fee paid by recipient. But for a certain periods, financial support is necessary to settle up IOPO. Our result can be used as a basic data for management plan of IOPO in the future.
Brain Death ; Brain Injuries ; Critical Pathways ; Emergencies ; Fees and Charges ; Financial Support ; Humans ; Insurance Coverage ; Korea ; Medical Records ; Tissue and Organ Procurement ; Tissue Donors

In Korea, brain death was established by the law in year 2000 but organ procurements from brain dead donors have been performed before the law era under the social tacit approval. Contrary to expectations, organ transplantation from brain dead donor have been much decreased in the law era. Electroencephalogram (EEG) is mandatory to confirm brain death in Korea. However EEG has several shortcomings and EEG wave may persist several hours after declaration of brain death by other tests. PURPOSE: To evaluate the significance of EEG and single photon emission computerized tomography (SPECT) as a confirming test of the brain death. METHODS: Clinical records of 42 cadaveric donor and their kidney recipients were reviewed retrospectively. Flat EEG was declared by two board certified neurologist or neurosurgeon. Tc99m-ECD SPECT was done in recent 10 donors who didn't show flat EEG at 24 hours after declarartion of brain death on clinical examination. And compared interval from renal transplantation to the moment when serum creatinine level went down below 2.0 mg/dl. RESULTS: Among 42 donors, 3 went to cardiac arrest while waiting flat EEG. And one another donor also went to cardiac arrest just after taking flat EEG. All the ten donors who took brain SPECT showed absence of cerebral blood flow. After showing circulatory arrest to the brain on SPECT another 3 to 23 hours were needed to get the flat EEG. There was no difference in interval between EEG only group (9.8 days) and EEG plus SPECT group (9.2 days). But the interval was prolonged in cardiac arrest group up to 20 days. CONCLUSION: We could get the falt EEG 3 to 23 hours after circulatory arrest to the brain on SPECT scan. While waiting to get flat EEG three donors went to cardiac arrest and kidneys from these cardiac arrest donor showed delayed graft function in all cases. Brain SPECT should be used as a confirming test of brain death.
Brain Death* ; Brain* ; Cadaver ; Creatinine ; Delayed Graft Function ; Electroencephalography ; Heart Arrest ; Humans ; Jurisprudence ; Kidney ; Kidney Transplantation ; Korea ; Organ Transplantation ; Retrospective Studies ; Tissue and Organ Procurement ; Tissue Donors ; Tomography, Emission-Computed, Single-Photon* ; Transplants

PURPOSE: Triple receptor-negative (TRN) breast cancer is associated with high risk of recurrence and poor prognosis. The present study assessed the clinicopathologic characteristics and ultrasound (US) features of TRN breast cancers. METHODS: Pathological and biological data were reviewed for 558 breast cancer patients treated at Kangbuk Samsung Hospital, between January 2003 and December 2009. The patients were separated into TRN breast cancer and non-TRN breast cancer groups, based on the results of immunohistochemical prognostic panels. Clinical and pathologic features were compared for the two groups. US features, including shape, orientation, margins, boundaries, echo patterns, posterior acoustic features, surrounding tissues, and microcalcifications, were determined for 41 TRN patients and 189 non-TRN controls (ER+/PR+/HER2-). RESULTS: Of 558 cases, 58 (10.4%) had the TRN phenotype. Four hundred and thirty-four cases (77.8%) were invasive ductal carcinomas. TRN cancer was significantly associated with specific characteristics of tumor size, nuclear grade, histologic grade, venous invasion, and lymphatic invasion. With respect to US features, TRN cancers were more likely to have an oval shape, a circumscribed margin, and marked hypoechogenicity. CONCLUSION: Tumor characteristics were different between TRN and non-TRN breast cancers, although US cannot differentiate the subtype of breast cancers TRN cancer tend to show somewhat different US morphology.
Acoustics ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Humans ; Orientation ; Phenotype ; Prognosis ; Recurrence

No abstract available.
Subcutaneous Fat*

Primary amyloidosis has unfavorable prognosis, particularly with organ involvement. Here, we report a case of clinical remission of renal amyloidosis after autologous hematopoietic cell transplantation. A 51-year-old female patient visited our hospital due to generalized edema. Initial evaluation showed hyperlipidemia, hypoalbuminemia, and heavy proteinuria, which were consistent with nephrotic syndrome. However, IgM lamda type monoclonal gammopathy was detected in serum and urine electrophoresis studies. Renal biopsy showed Congo red-positive amyloid deposition in mesangial area, glomerular capillary walls, and arterioles and amyloid fibers were confirmed by electron microscopy. Immunohistochemial study of the biopsy tissue demonstrated systemic light-chain amyloidosis (AL amyloidosis). Multiple myeloma was not evident on bone marrow examination. She received autologous hematopoietic cell transplantation after high dose melphalan treatment. Complete remissions were achieved after the treatment, respectively. Our findings suggest the potential role of autologous peripheral blood stem cell transplantation in treatment of AL amyloidosis.
Amyloid ; Amyloidosis* ; Arterioles ; Biopsy ; Bone Marrow Examination ; Capillaries ; Cell Transplantation ; Congo ; Edema ; Electrophoresis ; Female ; Humans ; Hyperlipidemias ; Hypoalbuminemia ; Immunoglobulin M ; Melphalan ; Microscopy, Electron ; Middle Aged ; Multiple Myeloma ; Nephrotic Syndrome ; Paraproteinemias ; Peripheral Blood Stem Cell Transplantation* ; Plaque, Amyloid ; Prognosis ; Proteinuria ; Transplants

Primary amyloidosis has unfavorable prognosis, particularly with organ involvement. Here, we report a case of clinical remission of renal amyloidosis after autologous hematopoietic cell transplantation. A 51-year-old female patient visited our hospital due to generalized edema. Initial evaluation showed hyperlipidemia, hypoalbuminemia, and heavy proteinuria, which were consistent with nephrotic syndrome. However, IgM lamda type monoclonal gammopathy was detected in serum and urine electrophoresis studies. Renal biopsy showed Congo red-positive amyloid deposition in mesangial area, glomerular capillary walls, and arterioles and amyloid fibers were confirmed by electron microscopy. Immunohistochemial study of the biopsy tissue demonstrated systemic light-chain amyloidosis (AL amyloidosis). Multiple myeloma was not evident on bone marrow examination. She received autologous hematopoietic cell transplantation after high dose melphalan treatment. Complete remissions were achieved after the treatment, respectively. Our findings suggest the potential role of autologous peripheral blood stem cell transplantation in treatment of AL amyloidosis.
Amyloid ; Amyloidosis* ; Arterioles ; Biopsy ; Bone Marrow Examination ; Capillaries ; Cell Transplantation ; Congo ; Edema ; Electrophoresis ; Female ; Humans ; Hyperlipidemias ; Hypoalbuminemia ; Immunoglobulin M ; Melphalan ; Microscopy, Electron ; Middle Aged ; Multiple Myeloma ; Nephrotic Syndrome ; Paraproteinemias ; Peripheral Blood Stem Cell Transplantation* ; Plaque, Amyloid ; Prognosis ; Proteinuria ; Transplants