No abstract available.
Burns* ; Humans ; Interleukin-2*

The authors reviewed the clinical findings and treatment results of 12 cases of spinal meningeal cysts which were detected in MRI of low back patients. In these lesions, large cysts without CSF communication can compressed the nerve roots within spinal canal and it is difficult to confirm the cause of symptom whether it is originated from cysts or from associated spinal disorders. The terms and classifications of spinal meningeal cysts were very confusing. Among 12 cases, we excised 3 cases of large cysts with gluteal and perianal pains that were caused by compressed sacral nerve roots. All three cases were type 2 cyst (classified by Nabors) and located in sacral canal. In one case associated with isthmic spondylolisthesis, posterolateral fusion and pedicle screw fixations were combined with cyst excision. In other two cases, there were not any spinal pathologic findings that compressed sacral nerve roots except mild degenerative changes and intervertebral disc herniation in lower lumbar and sacral levels All 3 excised cases showed good prognosis in more than one year follow up. The other cases were treated conservatively for the associated spinal disorders.
Classification ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging ; Prognosis ; Radiculopathy ; Spinal Canal ; Spondylolisthesis

OBJECTIVE: The aim of this study was to determine the optimal loading conditions for pure intrusion of the six maxillary anterior teeth with miniscrews according to alveolar bone loss. METHODS: A three-dimensional finite element model was created for a segment of the six anterior teeth, and the positions of the miniscrews and hooks were varied after setting the alveolar bone loss to 0, 2, or 4 mm. Under 100 g of intrusive force, initial displacement of the individual teeth in three directions and the degree of labial tilting were measured. RESULTS: The degree of labial tilting increased with reduced alveolar bone height under the same load. When a miniscrew was inserted between the two central incisors, the amounts of medial-lateral and anterior-posterior displacement of the central incisor were significantly greater than in the other conditions. When the miniscrews were inserted distally to the canines and an intrusion force was applied distal to the lateral incisors, the degree of labial tilting and the amounts of displacement of the six anterior teeth were the lowest, and the maximum von Mises stress was distributed evenly across all the teeth, regardless of the bone loss. CONCLUSIONS: Initial tooth displacement similar to pure intrusion of the six maxillary anterior teeth was induced when miniscrews were inserted distal to the maxillary canines and an intrusion force was applied distal to the lateral incisors. In this condition, the maximum von Mises stresses were relatively evenly distributed across all the teeth, regardless of the bone loss.
Alveolar Bone Loss* ; Finite Element Analysis* ; Incisor ; Tooth*

The displacement of an entire tooth into the adjacent anatomical area is an uncommon complication of a tooth extraction. We encountered a 23-year-old woman who had previously undergone surgery under local anesthesia to remove the lower third molar about 12 weeks prior and the upper third molar was extracted 2 days prior to visiting this hospital. Upon admission, she complained of a swallowing discomfort and a mouth opening limitation. Panoramic radiograph and a CT scan revealed a displacement of the entire tooth into the lateral pharyngeal space. The tooth was retrieved via the transoral approach under general anesthesia. The removed tooth had an indentation formed by a dental bur. Therefore, it was concluded that the tooth displaced into the lateral pharyngeal space was the lower third molar. This report describes an unusual case of a third molar that was displaced into the lateral pharyngeal space with a review of the relevant literature.
Anesthesia, General ; Anesthesia, Local ; Deglutition ; Female ; Humans ; Molar, Third* ; Mouth ; Tomography, X-Ray Computed ; Tooth ; Tooth Extraction ; Young Adult

A 46-year-old male patient had recurrent episodes of generalized pruritic wheals during hemodialysis. He has experienced urticaria during hemodialysis whenever he used a capillary dialyser sterilized by ethylene oxide(EO, Polysulfone-) gas which is used to sterilize hemodialysers and other medical equipment. On the other hand, capillary dialyser sterilized by Gamma ray (Hemophad) has not evoked urticaria. Although the presence of EO-specific antibodies was not detected, urticarial rash never developed when the equipment was switched to a gamma-sterilized one. We herein report a case referred to ethylene oxide induced cutaneous hypersensitivity during hemodialysis.
Antibodies ; Capillaries ; Ethylene Oxide ; Exanthema ; Gamma Rays ; Hand ; Humans ; Hypersensitivity* ; Kidneys, Artificial ; Male ; Middle Aged ; Renal Dialysis* ; Urticaria

The incidence of severe hepatitis A virus (HAV) infection has been increasing. However, clinicopathologic features of severe HAV infection that lead to liver transplantation (LT) have not been reported in Korea. We retrieved 16 LT cases with HAV infection during the last 3 years at Asan Medical Center, Seoul, Korea. Fifteen cases progressed to hepatic encephalopathy. Thirteen cases survived with or without complications, and three patients died of sepsis. The explanted liver showed massive or zonal necrosis with moderate to severe cholestasis. The zonal distribution of necrosis was frequently associated with endothelialitis of portal and/or central veins. Degenerative changes of hepatocytes were various in degree and distribution. Viral inclusions were suspected in two cases. Although HAV infection is usually confirmed by serological tests, significant venulitis of central and/or portal veins and viral inclusions, which are rarely observed, can suggest an HAV infection as a cause of massive hepatic necrosis of unknown mechanism.
Cholestasis ; Fluconazole ; Hepatic Encephalopathy ; Hepatitis ; Hepatitis A ; Hepatitis A virus ; Hepatocytes ; Humans ; Incidence ; Korea ; Liver ; Liver Transplantation ; Massive Hepatic Necrosis ; Necrosis ; Portal Vein ; Sepsis ; Serologic Tests ; Veins

No abstract available.

PURPOSE: To evaluate the outcome of ductal carcinoma in situ (DCIS) patients who underwent surgery followed by radiation therapy (RT). MATERIALS AND METHODS: We retrospectively reviewed 106 DCIS patients who underwent surgery followed by postoperative RT between 1994 and 2006. Ninety-four patients underwent breast-conserving surgery, and mastectomy was performed in 12 patients due to extensive DCIS. Postoperative RT was delivered to whole breast with 50.4 Gy/28 fx. Tumor bed boost was offered to 7 patients (6.6%). Patients with hormonal receptor-positive tumors were treated with hormonal therapy. RESULTS: The median follow-up duration was 83.4 months (range, 33.4 to 191.5 months) and the median age was 47.8 years. Ten patients (9.4%) had resection margin <1 mm and high-grade and estrogen receptor-negative tumors were observed in 39 (36.8%) and 20 (18.9%) patients, respectively. The 7-year ipsilateral breast tumor recurrence (IBTR)-free survival rate was 95.3%. Resection margin (<1 or > or =1 mm) was the significant prognostic factor for IBTR in univariate and multivariate analyses (p < 0.001 and p = 0.016, respectively). CONCLUSION: Postoperative RT for DCIS can achieve favorable treatment outcome. Resection margin was the important prognostic factor for IBTR in the DCIS patients who underwent postoperative RT.
Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Estrogens ; Follow-Up Studies ; Humans ; Mastectomy ; Mastectomy, Segmental ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Outcome*

PURPOSE:Recent studies proposed that polyunsaturated fatty acids (PUFA) of the omega6 series (linoleic acid, LA) compared to the omega 3 series (linolenic acid, LNA) may be a potent promoters of adipogenesis during the gestation/lactation period. Increased ratio of LA/LNA may stimulate adipose tissue development during gestation/lactation period and may subsequently lead to chilhood obesity. The purpose of this study is to evaluate fatty acids composition of the breast milk in Korean lactating women and to analyze the relationship between LA/LNA and the body weight gain of the infants. METHODS:Fifty eight healthy postpartum lactating women and their healthy 58 breast feeding infants were studied. At 11.3+/-3.9 days of postpartum, breast milk were taken and analyzed by gas-liquid chromatography with one-step methylation method. RESULTS:The total fat contents in breast milk were 3.2+/-1.3%. The total fat contents in breast milk were not related to maternal BMI or Kaup index of infants. The percentage of PUFA was 24.9+/-6.0%. Among these PUFA, the percentage of LA and LNA was 20.3+/-5.8% and 2.2+/-0.8%, respectively. LA/ LNA ratio was 10.2+/-2.5. There were no significant correlations between LA/LNA ratio and infant weight gain during the first 2 months of life. CONCLUSION: Short term weight gain of infant was not related to the LA/LNA ratio in the breast milk. Further studies on the long term effects on fat percent and body weight of infants would be needed.
Adipogenesis ; Adipose Tissue ; alpha-Linolenic Acid ; Body Weight* ; Breast Feeding ; Breast* ; Chromatography, Gas ; Fatty Acids* ; Fatty Acids, Unsaturated ; Female ; Humans ; Infant* ; Linoleic Acid ; Methylation ; Milk, Human* ; Obesity ; Postpartum Period ; Weight Gain

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted various aspects of daily living and has influenced the life of every individual in a unique way.Acute myocardial infarction (AMI) is associated with high morbidity and mortality; thus, timely treatment is crucial to prevent poor prognosis. Therefore, an immediate emergency department (ED) visit is required; however, no domestic studies have reported the effect of COVID-19 on ED visits by patients with AMI. Therefore, this study aimed to assess the changes in the pattern of ED visits by patients with AMI by comparing visits during the COVID-19 outbreak period to those during two control periods. Methods: This nationwide, retrospective study used registry data of the National Emergency Department Information System. The ‘outbreak period’ was defined as the period between February 21, 2020 and April 1, 2020, while the ‘control period’ was defined as the same time period in the preceding two years (2018 and 2019). The primary outcome of our study was the number of patients admitted to the ED owing to AMI during the outbreak and control periods. Secondary outcomes were time from symptom onset to ED visit, length of ED stay, and 30-day mortality following admission. Results: During the outbreak period, 401,378 patients visited the ED; this number was lower than that during the control periods (2018: 577,548; 2019: 598,514). The number of patients with AMI visiting the ED was lower during the outbreak period (2,221) than during 2018 (2,437) and 2019 (2,591). Conclusion The COVID-19 pandemic has caused a reduction in ED visits by patients with AMI. We assume that this could likely be caused by misinterpretation of AMI symptoms as symptoms of respiratory infection, fear of contracting severe acute respiratory syndrome coronavirus 2, and restrictions in accessing emergency medical care owing to overburdened healthcare facilities. This study sheds light on the fact that healthcare and emergency medical staff members must work towards eliminating hurdles due to this pandemic for patients to receive timely emergency care, which in turn will help curb the growing burden of mortality.