BACKGROUND: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. METHODS: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. RESULTS: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. CONCLUSIONS: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.
Acromion ; California ; Clavicle* ; Humans ; Osteolysis ; Periprosthetic Fractures ; Shoulder ; Skin

After Drainage implant surgery, erosion of conjunctiva or cornea over tube can occur about 5%in late postoperative period. Scleral allograft for exposed tube should be used to prevent secondary infection. We report three glaucoma patients treated graft with autologous buccal mucosal transplantation for recurrent tube exposure. First case was a 68-year-old male patient with neovascular glaucoma due to central retinal vein occlusion. Second case was a 37-year-old female patient with pseudophakic glaucoma. Third case was a 70-year-old male patient with diabetic neovascular glaucoma. Ahmed glaucoma valve implant surgeries were done for three patients. For tube exposure, we used autologous buccal mucosal transplantation. There was no recurrent erosion and intraocular pressure was maintained well more than 6 months of follow-up. In cases for tube exposure, we introduce that autologous buccal mucosal transplantation can be used to treat tube exposure.
Adult ; Aged ; Allografts* ; Coinfection ; Conjunctiva ; Cornea ; Drainage ; Female ; Follow-Up Studies ; Glaucoma* ; Glaucoma, Neovascular ; Humans ; Intraocular Pressure ; Male ; Postoperative Period ; Retinal Vein ; Transplants

Spinal cavernous hemangiomas of the cauda equina are extremely rare vascular malformations. We report a case of intradural extramedullary cavernous hemangioma of the cauda equina with it's clinical, radiologic and surgical findings. This is the twelveth case of cavernous hemangioma of the cauda equina in the literature. The pertinent literatures are reviewed.
Cauda Equina* ; Hemangioma, Cavernous* ; Vascular Malformations

PURPOSE: Foreign body aspiration in the tracheobronchial tree is a common medical emergency in children and represents an important cause of morbidity and mortality. This study was aimed to analyze the clinical spectrum of tracheobronchial foreign bodies in children and to evaluate the causes of late diagnoses. METHODS: A total of 108 patients with foreign body aspiration were recruited in the last 10 years, who had a flexible or rigid bronchoscopic examination. The age, sex, symptoms, causes of aspiration, radiologic findings, and clinical courses were investigated retrospectively. Patients were divided into 2 groups according to the elapsed time from aspiration to a definite diagnosis as early (< or =24 hours after aspiration) and late diagnoses (>24 hours after aspiration). The two groups were compared for clinical courses, radiologic findings, and the duration of admission of early- and late-diagnosed foreign body aspiration. RESULTS: Approximately 80% of the patients were less than 24 months of age and the most common symptoms were the sudden onset of a cough. Hyperinflation or obstructive emphysema (52.8%) and normal chest radiographs (19.4%) were the most frequent radiologic findings. Plain chest radiographies revealed visible foreign bodies in 7.4% of all patients with foreign body aspiration. Nuts were the most common foreign bodies aspirated. Sudden onset of a persistent cough and fever were predominant in the late-diagnosed group.(P<0.05) CONCLUSION: Our results suggest that clinical suspicion upon interviewing is enough to indicate bronchoscopy. The best way to reduce the number of accidents and deaths associated with foreign body aspiration is to promote public prevention polices.
Bronchoscopy ; Child ; Cough ; Delayed Diagnosis ; Diagnosis* ; Emergencies ; Emphysema ; Fever ; Foreign Bodies* ; Humans ; Mortality ; Nuts ; Radiography, Thoracic ; Retrospective Studies ; Thorax

Pneumothorax and pneumomediastinum can occur spontaneously, secondary to trauma, or from dissection of air from the neck or retroperitoneal space. The most common cause of traumatic pneumomediastinum is a rupture of the esophagus, which can occur during an episode of severe vomiting or, less frequently, following esophageal instrumention. We experienced a case of pneumothorax and pneumomediastinum, developed after esophageal perforation by stylet during difficult endotracheal intubation even though an esophagogram did not reveal the perforation site.
Esophageal Perforation* ; Esophagus ; Intubation, Intratracheal* ; Mediastinal Emphysema* ; Neck ; Pneumothorax* ; Retroperitoneal Space ; Rupture ; Vomiting

No abstract available.
Female ; HELLP Syndrome* ; Pregnancy

No abstract available.
Cause of Death* ; Fever* ; Humans

PURPOSE: Previously, acute rejection (AR) episode in the elderly recipients was reported to be lower compared to that of young recipients. However, the relationship between the recipients age, incidence of AR, and graft survival has not been reevaluated recently. METHODS: Four hundred thirty-one recipients who had the first kidney transplantation were recruited, and we performed a retrospective study evaluating the incidence of AR, infectious episodes in one year, and graft and patient survival rates at 1 and 5 years. We divided recipients into 2 groups (age< 50, n=340 and age=50, n=91) and compared the outcomes. RESULTS: The incidence of AR was 18.8% in the younger group and 24.2% in the elderly group (p=NS). The incidence of infectious episodes was 24.7% in the younger group and 24.2% in the elderly group (p=NS). Five-year graft survival in the elderly was not significantly different from that in the younger group (90.8% vs. 91.8%). However, the patient survival at five year was different between the younger and the elderly groups (99.1% and 92.2%, respectively, p<0.05). CONCLUSION: Our findings suggest that recipients age would not influence the incidence of AR and graft survival. Therefore, the immunosuppression should be applied according to the conditions of recipients, not to recipients age.
Aged ; Graft Rejection ; Graft Survival ; Humans ; Immunosuppression ; Incidence ; Kidney ; Kidney Transplantation ; Rejection (Psychology) ; Retrospective Studies ; Survival Rate ; Transplants

Whereas mesangial and epithelial cells from glomeruli are commonly grown in vitro, there has been major difficulties in developing homogenous cultures of human glomerular endothelial cells. This study defines the conditions for the reproducible isolation and growth of homogenous monolayers of human glomerular endothelial cells based on the method of Green DF et al published in 1992. Using the selective media and the sieving method, fibronectin was required as a surface matrix after adequate collagenase treatment, and endothelial cell growth factor and heparin was needed for the continuous growth of endothelial cells. The endothelial cell growth factor was isolated from the bovine hypothalamic extracts. Glomerular capillary endothelial cells exhibited a cobblestone morphology at confluence and stained homogenously with von Willebrand factor(factor VIII). The cytokeratin and the actin were not stained. This study might be helpful for in vitro study to know the biological characteristics of human glomerular endothelial cells under the predetermined condition.
Actins ; Cell Culture Techniques ; Collagenases ; Endothelial Cells* ; Epithelial Cells ; Fibronectins ; Heparin ; Humans* ; Keratins ; Population Characteristics

BACKGROUND: Perfusion scintigraphy with dipyridamole have been reported to be useful for diagnosis of coronary artery disease and the assessment of the presence and extent of myocardium at ischemic risk, especially in patients who can not undergo dynamic exercise testing. Dipyridamole, pharmacologic coronary vasodilator, also induces fall in blood pressure and rise in heart rate. The purpose of this study was to answer the question if dipyridamole induced peripheral hemodynamic responses were related to chest pain, ST changes on EKG, scintigraphic defect or extent of coronary stenosis. METHODS: Dipyridamole 99mTc-MIBI myocardial scintigraphy and coronary angiography on 43 subjects who were suspected to have coronary artery disease. The peripheral hemodynamic response was graded as absent(group 0) if there was a < or =10mm fall in systolic blood pressure (SBP) and/or < or =10 beats/min rise in geart rate(HR) ; moderate(group 1) if there was >10 but < or =20mm fall in SBP and/or >10 but < or =20 beats/min rise in HR ; and marked (group 2) if there was >20mm fall in SBP and/or >20 beats/min rise in HR. RESULTS: The overall diagnostic sensitivity and specificity for coronary artery disease of dipyridamole perfusion scintigraphy were 68%, 83% while per vessel sensitivity and specificity for coronary artery disease were 66%, 97%. The numbers of induced chest pain and ischemic ST changes among hemodynamic subgroups, were 40%, 40% in group 0, 33%, 27% in group 1 and 50%, 40% in group 2 without significant difference in each hemodynamic subgroups. Either the numbers of diseased coronary arteries or the numbers of patients demonstrationg reversible scintigraphic defects were not statically different among each subgroups. CONCLUSION: Although the peripheral hemodynamic response dose not always correlate with its central coronary effect but dipyridamlole 99mTc-MIBI myocardial perfusion scintigraphy is an useful test for diagnosis of coronary artery disease.
Blood Pressure ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis ; Dipyridamole* ; Electrocardiography ; Exercise Test ; Heart Rate ; Hemodynamics* ; Humans ; Myocardial Perfusion Imaging ; Myocardium ; Perfusion Imaging ; Sensitivity and Specificity