It has been suspected that the cannula of the ultrasonic generator became heated during liposuction, and that the heated cannula might possibly damage the soft tissues such as vessels, nerves and muscles. To confirm these suspicions, the actual temperature of the cannula was measured after being switched on, and the influence of the heated cannula on the soft tissues of 30 rabbits was studied macroscopically and microscopically. When the cooling system of ultrasonic generator was not operated, the temperature of a cannula tip increased to 100degrees C in 10 seconds, and the temperature of a cannula shaft did not increase over 40 degrees C. When the cooling system of the ultrasonic generator was operated, the temperature of the cannula tip increased to 70 degrees C in 20 seconds and to 100 degrees C in 1 minute. The stronger ultrasonic power was, the higher the temperature of the cannula tip was. When the heated cannnula tip touched the muscles, vesseles and nerves directly, the arterial and venous walls were perforated in about 20 seconds and 10 seconds, respectively. Gross changes of the muscles, such as color change and depression of the contacted area, were seen in about 30 seconds, and histological changes occurred in about 3 seconds. When adding the Klein solution, an infiltration solution for increasing the destructive effects of the ultrasound, the onset time of tissue damage was significantly shortened in vessels and nerves, but there was no significant difference in muscles. Although there was no finding of damage by the ultrasonic wave itself on the vessels, nerves, and muscles during ultrasonic liposuction, this study confirmed that the heated cannula could damage vessels, nerves, and muscles. Thus we must try to avoid placing the cannula at certain areas for more than 10 seconds douring the ultrasonic liposuction.
Catheters* ; Depression ; Hot Temperature ; Lipectomy* ; Muscles* ; Rabbits ; Ultrasonics* ; Ultrasonography

Inflammatory pseudotumor of the lung is considered to be a rare, benign, neoplastic lesion, consisting mainly of spindle mesenchymal cells, sometimes in such a way that its histological appearance mimics that of a spindle cell sarcoma, fibrous histiocytoma or fibrosarcoma. A case of inflammatory pseudotumor of the lung occurring in a 13-year-old boy is reported with pathologic findings, including its ultrastructure. The patient had had no symptoms and accidentally discovered his condition after a chest X-ray examination at a regular school physical check up. The mass was located in the suprahilar area of the left lung. Exploratory thoracotomy revealed a large mass that was removed, together with the left upper lobe of the lung. Microscopically, the mass was composed of numerous interstitial inflammatory cells, mainly lymphoplasma cells. Ultrastructurally, the spindle-shaped mesenchymal cells were arranged haphazadly and the normal pulmonary structure was nearly totally destroyed. Emphasis is given to complete resection of the tumor for both diagnostic and therapeutic purposes.
Adolescent ; Child ; Fibrosarcoma ; Granuloma, Plasma Cell ; Histiocytoma, Benign Fibrous ; Humans ; Lung ; Male ; Plasma Cell Granuloma, Pulmonary* ; Sarcoma ; Thoracotomy ; Thorax

No abstract available.
Factor VII Deficiency* ; Factor VII*

OBJECTIVE: The present study was undertaken to determine the value of developmental assessment, multimodality evoked potentials, brain magnetic resonance image (MRI) and electroencephalography (EEG) and to identify correlations between each evaluation. METHOD: Developmental assessments such as Bayley scales of infant development and Vineland social maturity scale, brain MRI, EEG and evoked potentials findings were evaluated in 45 children with spastic cerebral palsy to assess the developmental level and abnormalities of the anatomical structure of the brain and to elucidate the relationship between the test methods. RESULTS: 1) Mean mental developmental index (MDI) and psychomotor developmental index (PDI) were 69.6 and 68.6, respectively and mean Vineland social maturity quotient (SQ) was 76.1 and there was a significant correlation between the MDI, PDI, and SQ in cerebral palsied children. 2) Abnormal findings of brain MRI and EEG were found in 73.3% and 44.4% of the cases, respectively. 3) There was significant correlation between findings of brain MRI, auditory evoked potentials, visual evoked potentials, median somatosensory evoked potentials and social quotient. CONCLUSION: Developmental assessment, multimodality evoked potentials, EEG, and brain MRI would be a useful method to evaluate the maturity of brain and estimate the level of development.
Brain* ; Cerebral Palsy* ; Child Development ; Child* ; Electroencephalography* ; Evoked Potentials* ; Evoked Potentials, Auditory ; Evoked Potentials, Somatosensory ; Evoked Potentials, Visual ; Humans ; Magnetic Resonance Imaging* ; Weights and Measures

Purpose: We used a noninvasive ocular surface analyzer to explore changes in the ocular surface parameters of patients who underwent 25-gauge pars plana vitrectomy (PPV). Methods: The medical records of 82 patients (163 eyes) who underwent PPV were retrospectively reviewed. The non-invasive tear film break-up time (NIBUT), the lipid layer thickness, meibomian gland loss status, and the tear meniscus height were measured before, and 1 and 3 months after treatment. Consecutive changes in the ocular surface indices of operative and non-operative fellow eyes were statistically compared. Also, factors that reduced the NIBUT at 1 month after surgery were analyzed. Results: One month after surgery, the NIBUT was significantly decreased in the operative group compared to before surgery (p = 0.006). Compared to non-operative eyes, the NIBUT of operative eyes decreased significantly 1 month after surgery (p = 0.003). Older age and lower preoperative NIBUT (p = 0.029, p = 0.002) were significantly associated with lower NIBUT 1 month after surgery. Conclusions Twenty-five gauge PPV significantly reduces the NIBUT 1 month after surgery.

STUDY DESIGN: Retrospective study. OBJECTIVES: The goal of this study was to evaluate the risk factors of osteoporotic vertebral fractures (OVFs) in patients with Cushing syndrome. SUMMARY OF LITERATURE REVIEW: In most reports, vertebral fractures in Cushing syndrome have been found to be related to osteoporosis. However, few studies have analyzed the clinical risk factors for OVFs. MATERIALS AND METHODS: Thirty-two patients with Cushing syndrome who visited the orthopaedic department complaining of back pain were included in this study. Standing lateral X-rays were performed to evaluate the presence of vertebral fractures, and bone mineral density (BMD) was measured. RESULTS: Of the 32 patients with Cushing syndrome with back pain, 8 (25%) were diagnosed with OVFs using morphometric criteria. The average weight and body mass index of the vertebral fracture group (VF group) were significantly higher than the values observed in the non-vertebral fracture group (non-VF group) (p=0.004, p=0.018). Lumbar BMD was significantly lower in the VF group (p=0.006). A risk factor for OVFs in Cushing syndrome was osteoporosis (odds ratio=18.56, 95% confidence interval=1.72-200.21, p=0.016) regardless of gender, obesity, menopause, or urine free cortisol levels. CONCLUSIONS: OVFs in Cushing syndrome have been associated with overweight, and overweight is an indicator of compliance in the treatment of Cushing syndrome. Therefore, weight reduction and the prevention of osteoporosis should be emphasized in patients with Cushing syndrome to prevent OVFs.
Back Pain ; Body Mass Index ; Bone Density ; Compliance ; Cushing Syndrome* ; Female ; Humans ; Hydrocortisone ; Menopause ; Obesity ; Osteoporosis ; Overweight ; Retrospective Studies ; Risk Factors* ; Weight Loss

STUDY DESIGN: Retrospective evaluation. PURPOSE: To analyze the effect of T1 slope on degree of degeneration in patients with cervical disc degeneration. OVERVIEW OF LITERATURE: The T1 slope is well known parameter that may be very useful in evaluating sagittal balance. There are no reports on the analysis of the relationship between T1 slope and cervical disc degeneration. We hypothesized that T1 slope has an effect on the degree of cervical degeneration. METHODS: Sixty patients who had cervical spine magnetic resonance imaging (MRI) in our orthopedic clinic were enrolled. Patients were divided into two groups according to T1 slope. Radiologic parameters obtained from radiography and cervical spine MRI were compared between low T1 slope group (< or =25) and high T1 slope group (>25). RESULTS: Among low T1 slope group, average degeneration grade of each cervical segment was 2.65 in C2-3, 2.50 in C3-4, 2.62 in C4-5, 3.23 in C5-6, and 2.81 in C6-7. And that of high T1 group was 2.35 in C2-3, 2.32 in C3-4, 2.59 in C4-5, 2.79 in C5-6, and 2.32 in C6-7. Grade of degeneration of low T1 group was significantly higher, as compared with high T1 group in C5-6 (p=0.028) and C6-7 (p=0.009). Percentage of high grade degeneration of more than grand III was 65.4% in low T1 group and 32.4% in high T1 group (p=0.018). Risk of high grade degeneration of C6-7 was significantly higher in low T1 group (odds ratio, 5.63; 95% confidence interval, 1.665-19.057; p=0.005). CONCLUSIONS: Patients with low T1 slope had higher grade of degeneration regardless of age and gender. Low T1 slope is a potential risk factor of cervical spondylosis especially in the C6-7 cervical segment.
Humans ; Intervertebral Disc Degeneration* ; Magnetic Resonance Imaging ; Orthopedics ; Radiography ; Retrospective Studies ; Risk Factors ; Spine ; Spondylosis

Background/Aims: Unlike other gastrointestinal tract cancers, there are relatively few reports on the clinical significance of circulating tumor cells (CTCs) and TWIST, a marker of epithelial-mesenchymal transition, in patients with esophageal squamous cell carcinoma (ESCC). This study aimed to evaluate the clinical significance of TWIST expression in CTCs in patients with ESCC. Methods: Peripheral blood samples for CTC analyses were prospectively obtained from 52 patients with ESCC prior to treatment between September 2017 and September 2019. CTCs were detected using a centrifugal microfluidic system based on a fluid-assisted separation technique, and CTCs positive for TWIST on immunostaining were defined as TWIST (+) CTCs. Results: Of the 52 patients with ESCC, CTCs and TWIST (+) CTCs were detected in 44 patients (84.6%) and 39 patients (75.0%), respectively. The CTC and TWIST (+) CTC counts were significantly higher in patients aged >65 years and those who had a large tumor (>3 cm) thanin those aged ≤65 years and those who had a small tumor (≤3 cm), respectively. There were nodifferences in CTC and TWIST (+) CTC counts according to tumor location, histologic grade, or TNM stage. TWIST (+) CTCs were significantly associated with histologic grade; a proportion of TWIST (+) CTCs ≥0.5 was significantly associated with advanced histologic grade. Other clini-copathologic characteristics such as sex, age, tumor location, tumor size, and TNM stages were not significantly associated with TWIST (+) CTCs. Conclusions Our study showed that TWIST (+) CTCs were frequently detected in patients with ESCC, and a high proportion of TWIST (+) CTCs was associated with poor differentiation

OBJECTIVE: The aim of this study was to develop objective evaluation method of spasticity which reflects the characteristics of lengthening velocity-dependent stretch reflex of spasticity. METHOD: Kinematic analysis for knee angle and rectus femoris muscle lengthening parameters, and dynamic EMG were performed simultaneously during pendular movement of spastic lower leg for thirty two patients with spasticity and ten normal control subjects. Angular parameters consist of angular relaxation index (ARI), maximal angular velocity (MAV), angular threshold (AT) and angular velocity threshold (AVT). And lengthening parameters consist of lengthening relaxation index (LRI), maximal lengthening velocity (MLV), lengthening threshold (LT) and lengthening velocity threshold (LVT). RESULTS: 1) ARI, MAV, AT, and AVT according to Modified Ashworth scale (MAS) were 1.32+/-0.11, 303.84+/-45.11 deg/sec, 44.19+/-13.81 deg, 262.15+/-33.54 deg/sec in MAS I, 1.16+/-0.16, 279.92+/-42.94 deg/sec, 30.33+/-6.02 deg, 247.65+/-35.92 deg/sec in MAS II, and 0.95+/-0.14, 241.31+/-19.98 deg/sec, 20.55+/-2.68 deg, 209.11+/-48.11 deg/sec in MAS III (P<0.05). 2) LRI, MLV, LT, and LVT according to MAS were 1.27+/-0.11, 0.58+/-0.07, 1.164+/-0.14, 0.53+/-0.05 in MAS I, 1.12+/-0.09, 0.53+/-0.05, 1.150+/-0.08, 0.42+/-0.04 in MAS II, and 0.99+/-0.10, 0.44+/-0.01, 1.137+/-0.15, 0.36+/-0.02 in MAS III (P<0.05). 3) There were significant correlation between various pendulum test parameters and MAS. CONCLUSION: Muscle lengthening parameters as well as knee angular parameters were sensitive parameters reflecting the degree of spasticity. LVT is the most sensitive parameter among all parameters (p<0.01).
Humans ; Knee ; Leg ; Muscle Spasticity* ; Quadriceps Muscle ; Reflex, Stretch ; Relaxation