No abstract available.
Fistula* ; Thyroglossal Cyst*

Authors reviewed and clinically analysed 34 cases of trasometatarsal joint injury treated at the Orthopedic department of Pusan National University Hospital during the period from January 1975 to December 1979, and following results were obtained. 1. The incidence was higher in male and the active age group of 20-40. 2. Among the causes, traffic accidents were 22 cases (64.7%) and crushing injuries in the industrial field were 6 cases (17.6%). 3. Fracure-dislocations were higher than simple dislocation. 4. According to the Wilsons Classifications, the injuries were classified as follows. First stage of supination (51), 11 cases (32.4%): First stage of pronation (P1), 8 cases (23.5%): Plantar-flexion alone (PF), 4 cases (11.8%): Second stage of supination (S2), 3 cases (8.8%): Second stage of pronation (P2), 2 casese (5.9%): And finally direct crushing injuries,were 6 cases (17.6%): 5. Associated injuries were fracture of the metatarsal bone in 15 cases (44.1%), fractures of the tarsal bone in 7 cases (20.6%) and severe soft tissue injuries in 6 cases (17.6%), 6. The operative treatments with early anatomical reduction were obtained better results than conservative treatment. 7. As complications, pain in 31 cases (91.2%), bony deformity in 26 cases (76.5%), motion limitation in 32 cases (94.1%), skin necrosis in 3 cases (8.8%) and traumatic arthritis in 23 cases (67.6%) were observed.
Accidents, Traffic ; Arthritis ; Busan ; Classification ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Humans ; Incidence ; Joints ; Male ; Metatarsal Bones ; Necrosis ; Orthopedics ; Pronation ; Skin ; Soft Tissue Injuries ; Supination ; Tarsal Bones

Burst fractures of lower lumbar spine are rare and have not been well delineated in the literature. Treatment and management considerations for lower lumbar burst fractures are somewhat different from the rest of spine because this area only has the cauda equina and nerve roots. The purpose of this study was to analyse the clinical and radiological results and to determine operative approach. The authors analysed the 16 patients who had been treated with spinal instrumentation (Cotrel- Dubousset, Danek, Kaneda) from Dec. 1990 to Dec. 1994, and following results were obtained. 1. The classification of fracture by Francis-Denis method was B type in 7 cases, A type in 6 cases, E type in 2 cases, and D type in 1 case. 2. By the load-sharing classification, six points or less in 11 patients (first group) and seven or more in 5 patients (second group). In first group lordosis was corrected from 20.4degreespreoperatively to 32.6degrees postoperatively and 24.1degrees at the end of follow-up. In second group lordosis was corrected from 14.8degrees preoperatively to 21.3degrees postoperatively and 0.8degrees at the end of follow-up. 3. The short segmental fixation through posterior approach yielded good result in the first group, but poor result in the second group with complications including two cases of loss of reduction and one case of screw breakage. As a result, posterior approach might be more perferable in first group and anterior approach in the second group.
Animals ; Cauda Equina ; Classification ; Follow-Up Studies ; Humans ; Lordosis ; Spine

PURPOSE: To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer. MATERIALS AND METHODS: Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using 192Ir between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions. RESULTS: The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT +/- external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (< or =grade 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention. CONCLUSION: HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.
Brachytherapy* ; Humans ; Mouth Neoplasms ; Mouth* ; Radiotherapy ; Recurrence ; Retrospective Studies

Endomyocardial biopsy (EMB) is a valuable diagnostic procedure for the surveillance of cardiac allograft rejection. Interpretation of individual cases is still problematic due to variations of findings for grading of rejection and other associated lesions. We reevaluated an experience on endomyocardial biopsies to develop better diagnostic criteria for rejection and other complications. Immunohistochemical studies against cytokines were performed to assess the usefulness of the method for the diagnosis or researches. A total of 249 EMBs taken from 33 cardiac allograft recipients were reviewed. There were 25 males and 8 females. Dilated cardiomyopathy was present (24 cases) and valvular heart disease (4 cases), restrictive cardiomyopathy (3 cases) were also common conditions. We applied the grading system of the International Society for Heart Transplantation (ISHT) for the assessment of acute cellular rejection. Grades of 0, 1A, 1B, 2, 3A and 3B were 39.0%, 28.1%, 11.2%, 11.5%, 12.4% and 1.6% respectively, but 3.2% were inadequate. Thirty five episodes of grade 3A or 3B were present in 17 patients. The response to therapy was assessed using a next follow up biopsy, which revealed resolving or resolved rejection in 85% of patients. The intensity of immunohistochemical stains for IL-6 and TNF-alpha was increased in proportion to the histologic grade but Quilty lesion and cardiomyopathy also showed a positive reaction. The other pathologic findings were ischemic change, previous biopsy site, interstitial edema and fibrosis, and Quilty lesion. These findings showed usefulness of endomyocardial biopsy not only for the evaluation of cardiac allograft rejection but also for the diagnosis of associated cardiac lesions. Immunohistochemical study of the cytokines was related to the degree of inflammation rather than degree of rejection.
Allografts ; Biopsy* ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cardiomyopathy, Restrictive ; Coloring Agents ; Cytokines ; Diagnosis ; Edema ; Female ; Fibrosis ; Follow-Up Studies ; Heart Transplantation* ; Heart Valve Diseases ; Heart* ; Humans ; Inflammation ; Interleukin-6 ; Male ; Tumor Necrosis Factor-alpha

OBJECTIVE: The purpose of this study was to analyze the clinical study for patients with cervical cancer who had undergone radical hysterectomy. METHOD: The subjects of this study were one hundred and sixty two patients with cervical cancer who had undergone radical hysterectomy at Eulji Medical College Hospital, Taejon, Korea, from January 1983 to December 1992. We reviewed the medical record retrospectively and analyzed the data. RESULT: The distribution of patients by age was found in the order of 50 decade and 60 decade, 40 decade. Those by the clinical stages were as follows: Stage Ia, 12 cases(7.4%); Stage Ib, 84 cases(51.9%); Stage IIa, 39 cases(24.1%); Stage IIb 27 cases(16.7%). The results of histopathologic type were distributed as follows: squamous cell carcinoma was 91.9%, adenocarcinoma was 4.9% and adenosquamous cell carcinoma was 3.1%. The histologic subtypes of squamous cell carcinoma(149 cases) were as follows: Large cell non-keratinizing type was 75.9%, large cell keratinizing type was 14.8% and small cell type was 1.2%. The frequancy of lymph node metastasis was 22.9% in stage I and 31.8% in stage II. The overall incidence of lymph node metastasis was 26.4%. The frequency of external radiation therapy done after radical hysterectomy was 63.5% in stage I and 75.8% in stage II. The 5-year survival rate was as follows: The Ia was 100%; Stage Ib, 95.2%(4cases); Stage IIa, 87.2%(5cases); Stage IIb, 77.8%(6cases). The incidence of recurrence was 7.4% and recurrent sites were vaginal stump , rectum and pelvic wall. CONCLUSION: The highest incidence of cervix cancer in age distribution was 50 decade(30.9%) and 60 decade(30.9%). The most common clinical stage was Ib(51.9%) and most frequent pathologic type was squamous cell carcinoma(91.9%). The overall incidence of lymph node metastasis was 26.4% and The most common site of recurrence was vaginal stump. The 5-year survival rate was 100% in the stage Ia, 95.2% in the stage Ib, 87.2% in the stage IIa, 77.8% in the stage IIb.
Adenocarcinoma ; Age Distribution ; Carcinoma, Squamous Cell ; Daejeon ; Humans ; Hysterectomy* ; Incidence ; Korea ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Rectum ; Recurrence ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

PURPOSE: The aim of the present study was to assess the clinicopatholgical significance of Bcl-2 oncoprotein expression in childhood non-Hodgkin's lymphoma (NHL). METHODS: We have assessed 16 cases of childhood NHL during last 6 years from 1990 to 1995. Bcl-2 oncoprotein expression has been semiquantitatively analyzed in paraffin sections from 16 cases of childhood NHL with 39 control cases of adult NHL. The expression of Bcl-2 oncoprotein was correlated with histologic grade, immunophenotype, proliferative activity as measured by immunostain of Ki-67 antigen, clinical stage, and survival rate (event free survival rate, EFS). RESULTS: 1) Bcl-2 oncoprotein expression significantly decreased according to increase of histological grade (P<0.05). 2) High Bcl-2 oncoprotein expression was more frequent in B-cell NHL than T-cell NHL (P<0.05). 3) Proliferative activity as measured by immunostain of Ki-67 antigen was negatively correlated with Bcl-2 oncoprotein expression (P<0.05). 4) Bcl-2 oncoprotein expression was not correlated with clinical stage (P>0.05). 5) EFS of patients was significantly correlated with Bcl-2 oncoprotein expression, that is, reduced EFS was demonstrated in the patients with low Bcl-2 oncoprotein expression (P<0.05). CONCLUSIONS: Thus Bcl-2 oncoprotein, as demonstrated immunohistochemically in routinely paraffin embedded tissue, can be restrictively used in prediction of prognosis and grade of childhood NHL, in aggrement with the role of Bcl-2 oncoprotein in blocking of apoptosis and indirect contribution to increase of cellular proliferative activity of NHL.
Adult ; Apoptosis ; B-Lymphocytes ; Child ; Humans ; Ki-67 Antigen ; Lymphoma, Non-Hodgkin* ; Paraffin ; Prognosis ; Survival Rate ; T-Lymphocytes

Distal renal tubular acidosis (RTA) is well-recognized complication of immunologically mediated condition such as Sj ogren's syndrome, SLE, idiopathic hypergammaglobulinemia, autoimmune liver disease, autoimmune thyroid disease, multiple myeloma, and renal tranplant rejection. Tubulointerstitial involvement frequently occurrs in SLE. A sepctrum of abnormalities including impaired uriary concentration or acidification, increased fractional excretion of low molecular weight protein, hyporeinaemic hypoaldosteroniam and impaired tubular potassium excretion can occur in SLE. But complete distal RTA associated wih SLE is rare. We report a 13 year-old female with SLE and distal RTA which was diagnosed by NaHCO3 loading test. She had nephrotic syndrome, hypokalemia, hyperchloremic metabolic acidosis with alkali urine. She had fatiquebility, general weakness, intermittent fever and chest pain for at least 12months. And then, the butterfly-shaped malar rash was developed, so pediatrician suspected SLE and she was refer to us. At hospitalization. She had malar rash, percardial effusion, persistent proteinuria greater than 3+, hemolytic anemia, lymphopenia, leukopenia, positive LE cell, Anti-DNA Ab and posotive ANA. So her clinical data are satisfied ARA criteria for SLE. Her renal biopsy showed diffuse proliferative SLE nephpritis and marked focal tubular atrophy with localized heavy mononuclear cell infiltration and fibrosis. We performed NaHCO3 loading test to confirm distal RTA. During the test, we detected the inability to achieve a high urinary PCO2. This result is the most sensitive index of impaired distal acidification, so we can diagnose distal RTA. She had a good response to the therapy with prednisolone NaHCO3 and oral KCL supplement.
Abdominal Pain ; Acidosis ; Acidosis, Renal Tubular* ; Adolescent ; Alkalies ; Anemia, Hemolytic ; Atrophy ; Biopsy ; Chest Pain ; Child, Preschool ; Diagnosis* ; Exanthema ; Female ; Fever ; Fibrosis ; Hospitalization ; Humans ; Hypergammaglobulinemia ; Hypokalemia ; Intestinal Volvulus* ; Leukopenia ; Liver Diseases ; Lupus Erythematosus, Systemic* ; Lymphopenia ; Melena ; Mesentery ; Molecular Weight ; Multiple Myeloma ; Nephrotic Syndrome ; Neutrophils ; Potassium ; Prednisolone ; Proteinuria ; Thyroid Diseases ; Tomography, X-Ray Computed*

Distal renal tubular acidosis (RTA) is well-recognized complication of immunologically mediated condition such as Sj ogren's syndrome, SLE, idiopathic hypergammaglobulinemia, autoimmune liver disease, autoimmune thyroid disease, multiple myeloma, and renal tranplant rejection. Tubulointerstitial involvement frequently occurrs in SLE. A sepctrum of abnormalities including impaired uriary concentration or acidification, increased fractional excretion of low molecular weight protein, hyporeinaemic hypoaldosteroniam and impaired tubular potassium excretion can occur in SLE. But complete distal RTA associated wih SLE is rare. We report a 13 year-old female with SLE and distal RTA which was diagnosed by NaHCO3 loading test. She had nephrotic syndrome, hypokalemia, hyperchloremic metabolic acidosis with alkali urine. She had fatiquebility, general weakness, intermittent fever and chest pain for at least 12months. And then, the butterfly-shaped malar rash was developed, so pediatrician suspected SLE and she was refer to us. At hospitalization. She had malar rash, percardial effusion, persistent proteinuria greater than 3+, hemolytic anemia, lymphopenia, leukopenia, positive LE cell, Anti-DNA Ab and posotive ANA. So her clinical data are satisfied ARA criteria for SLE. Her renal biopsy showed diffuse proliferative SLE nephpritis and marked focal tubular atrophy with localized heavy mononuclear cell infiltration and fibrosis. We performed NaHCO3 loading test to confirm distal RTA. During the test, we detected the inability to achieve a high urinary PCO2. This result is the most sensitive index of impaired distal acidification, so we can diagnose distal RTA. She had a good response to the therapy with prednisolone NaHCO3 and oral KCL supplement.
Abdominal Pain ; Acidosis ; Acidosis, Renal Tubular* ; Adolescent ; Alkalies ; Anemia, Hemolytic ; Atrophy ; Biopsy ; Chest Pain ; Child, Preschool ; Diagnosis* ; Exanthema ; Female ; Fever ; Fibrosis ; Hospitalization ; Humans ; Hypergammaglobulinemia ; Hypokalemia ; Intestinal Volvulus* ; Leukopenia ; Liver Diseases ; Lupus Erythematosus, Systemic* ; Lymphopenia ; Melena ; Mesentery ; Molecular Weight ; Multiple Myeloma ; Nephrotic Syndrome ; Neutrophils ; Potassium ; Prednisolone ; Proteinuria ; Thyroid Diseases ; Tomography, X-Ray Computed*

This study evaluated the outcomes of off-pump coronary artery bypass surgery (OPCAB) with severe left ventricular dysfunction using composite bilateral internal thoracic artery grafting. From January 2001 to December 2008, 1,842 patients underwent primary isolated OPCAB with composite bilateral internal thoracic artery grafting. A total of 131 of these patients were diagnosed with a severely depressed preoperative left ventricle ejection fraction (LVEF) (< or =0.35). These patient outcomes were compared with the outcomes of 830 patients that had mildly or moderately depressed LVEF (0.36 to 0.59) and 881 patients with normal LVEF (>0.6). The early mortality for patients with severe LVEF was 2.3%. The 3-yr and 7-yr survival rate for patients with severe LV dysfunction was 86.0% and 82.8%, respectively. Multivariate analysis showed that severe LV dysfunction EF increased the risk of all-cause death (P=0.012; hazard ratio [HR],2.14; 95% confidence interval [CI],1.19-3.88) and the risk of cardiac-related death (P=0.008; HR,3.38; 95% CI, 1.37-8.341). The study identified positive surgical outcomes of OPCAB, although severe LVEF was associated with two-fold increase in mortality risk compared with patients who had normal LVEF.
Coronary Artery Bypass, Off-Pump/methods/*mortality ; Female ; Heart ; Humans ; Male ; Mammary Arteries/*transplantation ; Middle Aged ; Retrospective Studies ; Stroke Volume ; Survival Rate ; Treatment Outcome ; Vascular Grafting/methods/*mortality ; Ventricular Dysfunction, Left/mortality/*surgery ; Ventricular Function, Left