BACKGROUND: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. METHODS: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). RESULTS: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. CONCLUSIONS: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.
Elbow ; Follow-Up Studies ; Fracture Fixation* ; Humans ; Humeral Fractures ; Humerus* ; Muscles ; Peripheral Nervous System Diseases ; Traction ; Transplants ; Treatment Outcome

PURPOSE: To evaluate the clinical outcomes, complications and surgically induced astigmatism (SIA) after scleral fixation in patients with intraocular lens (IOL) or crystalline lens dislocation. METHODS: The present study retrospectively investigated the postoperative best corrected visual acuity (BCVA), refractory change, corneal astigmatism, clinical outcomes, and influencing factors of SIA in 57 eyes of 55 patients with a follow-up of 6 months after the IOL scleral fixation. RESULTS: In comparison of preoperative and postoperative 6 months, BCVA, spherical equivalent and astigmatism were significantly improved but corneal astigmatism was not and SIA (diopter, D) improved from 2.10 +/- 1.88 D to 0.86 +/- 0.73 D (p = 0.002). 4 eyes having redislocation were repositioned and 4 eyes having tilted IOL, 6 eyes having elevated intraocular pressure, 3 eyes having exposure scleral knots, 1 eye having endophthalmitis, and 1 eye showing macular edema were observed. At postoperative 3 months, the SIA of a large incision size (>3 mm) and small incision size (< or =3 mm) was significantly differented (p = 0.041). According to the location of scleral fixation, SIA at postoperative 1 month was significantly different but, was not different at postoperative 6 months. CONCLUSIONS: Surgical management of dislocated IOLs or crystalline lens resulted in significant improvement of visual acuity and absence of influencing SIA factors. However, location of scleral fixation and small incision size influenced corneal astigmatism.
Astigmatism ; Dislocations ; Endophthalmitis ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Lens, Crystalline ; Lenses, Intraocular ; Macular Edema ; Retrospective Studies ; Visual Acuity

No abstract available.
Myotonic Dystrophy* ; Thoracic Surgery, Video-Assisted* ; Thymoma*

Cartilage, Articular ; Cell Line ; Chondrocytes ; Electrophoresis ; Interleukin-2 ; Mass Screening ; Phosphotransferases ; Proteome ; Temporomandibular Joint ; Temporomandibular Joint Disorders

Objective: The present study aimed to analyze the correlation between platelet-to-lymphocyte ratio (PLR) and platelet-to-neutrophil ratio (PNR) with prognosis of patients who underwent mechanical thrombectomy (MT). Methods: A total of 432 patients was included, PLR and PNR were calculated from laboratory data on admission. Prognosis was evaluated with a modified Rankin Scale at 3 months after MT. Using receiver operating characteristic (ROC) analysis, optimal cutoff values of PLR and PNR were identified to predict the prognosis after MT. Multivariate analyses were performed to identify the relationship of PLR and PLR with prognosis of MT. Results: Patients with favorable outcomes had a lower mean PLR (135.0, standard deviation [SD] 120.3) with a higher mean PNR (47.1 [SD] 24.6) compared with patients with unfavorable outcomes (167.6 [SD] 139.3 and 35.4 [SD] 22.4) (p<0.001 and <0.001, respectively). In ROC analyses, the optimal cutoff value of PLR and PNR to predict the 3 months prognosis were 145 and 41, respectively (p=<0.001 and p=0.006). In multivariate analysis, PLR less than 145 (odds ratio [OR] 1.29, 95% confidence interval [CI] 1.06–2.06; p=0.016) and PNR greater than 41 (OR 1.22, 95% CI 1.10–1.62; p=0.022) were predictors of favorable outcome at 3 months. Conclusions In patients with MT, PLR and PNR on admission could be predictive factors of prognosis and mortality at 3 months. Decreased PLR and increased PNR were associated with favorable clinical outcome 3 months after MT.

PURPOSE: Electric injury may result in cataracts, which usually occur bilaterally. In this report, we present a rare complication of such an injury presenting as a unilateral cataract with optic neuropathy. CASE SUMMARY: A 17-year-old male patient presented with gradual worsening of vision in his right eye 7 weeks after sustaining an injury from 22,900 volts of high-voltage electric current his right hand. On initial eye examination, the best corrected visual acuity (BCVA) was 20/60 in the right eye and 20/20 in the left eye. Relative afferent pupillary defect (RAPD) was noted in the right eye. Slit-lamp examination confirmed the typical anterior subcapsular lenticular opacities and funduscopy showed a slightly pale optic nerve head in the right eye. Pattern reversal visually evoked potential (P-VEP) showed a significant delay of P-100 implicit time in the right eye. After 7 months, phacoaspiration and posterior chamber intraocular lens implantation were performed in the right eye. Postoperatively, the BCVA improved to 20/30 but visual field examination showed a partial defect in the temporal area of the right eye. Cataract did not develop in the left eye during 15 months of follow-up. The electron microscopic findings showed that the number of mitochondria in the cytoplasm increased. The rough endoplasmic reticulum in the cytoplasm and microfilaments were enriched. CONCLUSIONS: Manifestation time of ocular complications after electric injuries is different. Therefore an ophthalmic examination should be performed regularly in the early recovery period of such injuries and in particular, progression of bilateral electric cataract must be checked.
Actin Cytoskeleton ; Cataract ; Cytoplasm ; Electric Injuries ; Electrons ; Endoplasmic Reticulum, Rough ; Evoked Potentials ; Eye ; Follow-Up Studies ; Hand ; Humans ; Lens Implantation, Intraocular ; Male ; Mitochondria ; Optic Disk ; Optic Nerve Diseases ; Pupil Disorders ; Vision, Ocular ; Visual Acuity ; Visual Fields

Chronic lymphocytic leukemia (CLL) is a unique indolent B-cell leukemia which is rare in Korea. Many patients with early stage CLL do not require immediate treatment, while those with advanced stage or symptoms need systemic chemotherapy. As our understanding about the pathophysiology of CLL increases, significant advances have been achieved in the treatment of this disease. Modern molecular genetics have been revealing remarkable heterogeneity of various genetic alterations and the corresponding prognostic stratification in CLL. The treatment of CLL had been developed from nitrogen mustard alkylating agent like chlorambucil to combination therapy including purine analogues like pentostatin and fludarabine until early 2000s. Since the introduction of targeted agent like anti-CD20 and anti-CD52 monoclonal antibodies in the treatment of CLL, the treatment outcome of CLL has leaped further. In conclusion, one of the current standard regimens in patients with untreated CLL is the combination of rituximab, cyclophosphamide and fludarabine. We recently passed the entrance for the era of targeted therapy, and are exploring various new agents and their combinations.
Antibodies, Monoclonal ; Antibodies, Monoclonal, Murine-Derived ; Chlorambucil ; Cyclophosphamide ; Humans ; Korea ; Leukemia, B-Cell ; Leukemia, Lymphocytic, Chronic, B-Cell ; Mechlorethamine ; Molecular Biology ; Pentostatin ; Population Characteristics ; Prognosis ; Purines ; Treatment Outcome ; Vidarabine ; Rituximab

BACKGROUND: Many investigators have advocated neural and especially regional sympathetic blockade for acute herpe. zoster pain. Some believe that nerve blocks not only relieve acute pain but also, if given early in the course of clinical disease, prevent progression to postherpetic neuralgia. OBJECTIVE: The purpose of this study was to evaluate the preventive effect of sympathetic blockade on herpes zoster METHODS: Fifteen patients with herpes zoster were treated with sympathetic blocks according to the severity of pain. RESULTS: The total score of pain degree decreased from 3.4 to 1.1 with sympathetic blocks in 15 patients in 2 months. Sympathetic blocks prevented or relieved postherpetic neuralgia in more than 90% of patients treated within 2 weeks of the onset of the acute phase of the disease and in more than 85% of patients over 60. CONCLUSION: Sympathetic blocks are effective in preventing postherpetic neuralgia if applied soon after the onset of the acute phase of herpes zoster.
Acute Pain ; Herpes Zoster ; Humans ; Nerve Block ; Neuralgia, Postherpetic* ; Research Personnel

No abstract available.
Central Nervous System* ; Sjogren's Syndrome ; Tics*