PURPOSE: evaluate the radiologic and clinical results of modified step-cut osteotomy for correction of cubitus varus deformity in children. MATERIALS AND METHODS: We analysed 16 children who had varus deformity preoperatively and received modified step-cut osteotomy. The results were evaluated by final follow-up radiographs and clinical results, which were humeral-elbow-wrist angle, lateral prominence, range of motion and complications. RESULTS: The average preoperative humeral-elbow-wrist (HEW) angle was -15.8degrees and average last follow-up HEW angle was +6.7degrees Lateral prominence under 5 mm occurred in 3 cases and one children showed limited motion and transient ulna neuropathy. CONCLUSION: The results demonstrate that modified step-cut osteotomy achieve good correction of cubitus varus without lateral bony prominence or complications.
Child* ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Humerus* ; Osteotomy* ; Range of Motion, Articular ; Ulna

BACKGROUND: Tumor-associated macrophages (TAMs) play a tumorigenic role related to advanced staging and poor prognosis in many human cancers including thyroid cancers. Yet, a functional role of TAMs in papillary thyroid carcinoma (PTC) has not been established. The aim of this study was to investigate TAM expression in human PTC with lymph node (LN) metastasis. METHODS: Thirty-six patients who underwent surgery after being diagnosed with PTC with LN metastasis were included. Primary tumor tissues were immunohistochemically stained with an anti-CD68 antibody and clinical characteristics according to TAM density were evaluated. RESULTS: The TAM densities (CD68+ cells) varied from 5% to 70%, in all tumor areas, while few cells were stained in adjacent normal tissues. TAMs were identified as CD68+ cells with thin, elongated cytoplasmic extensions that formed a canopy structure over tumor cells. Comparing clinicopathologic characteristics between tumors with low (<25%) and high (25% to 70%) TAM densities, primary tumors were larger in the high density group than in the low density group (2.0+/-0.1 vs. 1.5+/-0.1; P=0.009). CONCLUSION: TAMs were identified in primary PTC tumors with LN metastasis and higher TAM densities were related to larger tumor sizes, suggesting a tumorigenic role of TAMs in human PTCs.
Carcinoma ; Cytoplasm ; Factor IX ; Humans ; Lymph Nodes ; Macrophages ; Neoplasm Metastasis ; Prognosis ; Thyroid Gland ; Thyroid Neoplasms

PURPOSE: Cervical lymph node metastasis is the most important factor of the prognosis and therapeutic planning in head and neck cancer. With increasing interest of minimally invasive neck surgery, more accurate preoperative assessment of cervical lymph node becomes more essential. We evaluated the diagnostic accuracy of 18F FDG-PET in the assessment of lymph node metastasis in patients with primary head and neck cancer and compared the results with those of CT/MRI. MATERIALS AND METHODS: Thirty-two patients (M/F=27/5, 56 +/- 10yr) with biopsy proven head and neck cancer (16 supraglottic cancer, 9 tongue cancer, 7 others) underwent FDG-PET and CT/MRI (25/7) within 1 month before neck dissection. Based on lymph node level, the diagnostic sensitivity and specificity of FDG PET and CT/MRI for the metastasis of cervical lymph node were compared. RESULTS: Of 153 lymph node levels dissected in 32 patients, 32 lymph node levels of 19 patients were positive for metastasis by histopatholologic examination. The overall sensitivity and specificity of FDG-PET were 88% (28/32) and 93% (113/121), whereas those of CT/MRI were 56% (18/32) (p=0.002) and 92% (112/121), respectively. The diagnostic sensitivity and specificity of FDG-PET were different according to location of lymph node levels, and those of ipsilateral level II were lower than those of other levels. CONCLUSION: FDG-PET is more sensitive in detecting metastatic cervical lymph node in head and neck cancer than CT/MRI. FDG-PET might be useful in guiding the extent of neck dissection.
Biopsy ; Diagnosis* ; Head and Neck Neoplasms* ; Head* ; Humans ; Lymph Nodes* ; Neck ; Neck Dissection ; Neoplasm Metastasis* ; Prognosis ; Sensitivity and Specificity ; Tongue Neoplasms

Gamma-glutamyltranspeptidase (GGT) was purified to electrophoretic homogeneity from the cell extract of H. pylori. The purified enzyme consisted of heavy and light subunits with molecular weights of 38 kDa and 21 kDa, respectively. N-terminal amino acid sequence of heavy and light subunits revealed that H. pylori GGT was processed into 3 parts for a signal peptide of 27 amino acid residues, a heavy subunit of 352 residues, and a light subunit of 188 residues during translation. The reaction rate for hydrolysis of gamma-GpNA was 84.4 micromol/min per milligram of protein, and that for the gamma-glutamyl transfer from gamma-GpNA to gly-gly was 23.8 micromol/min per milligram of protein. The apparent Km values of H. pylori GGT for gamma-glutamyl compounds were on the order of 10-3 to 10-4 M and those for acceptor peptides and amino acids were on the order of 10-1 to 10-2 M. The GGT protein kept approximately 80% of the initial enzymatic activity on incubation at 60degrees C for 15 min. The optimum temperature and pH for reactions of both hydrolysis and transpeptidation were 40degrees C and 9.0, respectively. The transpeptidation and hydrolysis reactions catalyzed by H. pylori GGT were strongly inhibited by L-Gln and moderately inhibited by L-Ala, L-Ser, beta-chloro-L-Ala, and L-Glu. These results demonstrated that the biochemical properties of H. pylori GGT are different from those of other bacterial GGTs. Further, H. pylori GGT might degrade glutathione in the gastric mucous layer of humans if the enzyme could be secreted in the bacterial niches.
Amino Acid Sequence ; Amino Acids ; Glutathione ; Helicobacter ; Helicobacter pylori ; Humans ; Hydrogen-Ion Concentration ; Hydrolysis ; Light ; Molecular Weight ; Peptides ; Protein Sorting Signals

OBJECTIVES: The aim of this multicenter registry study was to investigate the effectiveness of ventilation tube insertion and the microbiology of otitis media with effusion (OME) in children. This part I study was conducted to evaluate the microbiological profile of children with OME who needed ventilation tube insertion. METHODS: Patients < 15 years old who were diagnosed as having OME and received ventilation tube insertion were prospectively enrolled in 16 tertiary hospitals from June 2014 to December 2016. After excluding patients with missing data, the data of 397 patients were analyzed among a total of 433 enrolled patients. The clinical symptoms, findings of the tympanic membrane, hearing level, and microbiological findings were collected. RESULTS: In 103 patients (25.9%), antibiotics were used within 3 weeks before surgery. Ventilation tube insertion was performed in a total of 710 ears (626 in both ears in 313 patients, 55 in the left ear only, and 29 in the right ear only). Culture of middle ear effusion was done in at least one ear in 221 patients (55.7%), and in a total of 346 ears. Only 46 ears (13.3%) showed positive results in middle ear effusion culture. Haemophilus influenzae (17.3%, followed by coagulase-negative Staphylococcus and Staphylococcus auricularis) was the most common bacteria detected. CONCLUSION: H. influenzae was the most commonly found bacteria in middle ear effusion. Relatively low rates of culture positivity were noted in middle ear effusion of patients with OME in Korea.
Anti-Bacterial Agents ; Bacteria ; Child ; Ear ; Ear, Middle* ; Haemophilus influenzae ; Hearing ; Humans ; Influenza, Human ; Korea ; Middle Ear Ventilation ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Prospective Studies ; Staphylococcus ; Tertiary Care Centers ; Tympanic Membrane ; Ventilation*

Objectives: . The impacts of ventilation tube (VT) type and effusion composition on the VT extrusion rate and complications in children with otitis media remain unclear. This part II study evaluated the factors affecting the extrusion rate, recurrence rate, and complications of VT insertion. Methods: . A prospective study was conducted between June 2014 and December 2016 (the EVENT study [analysis of the effectiveness of ventilation tube insertion in pediatric patients with chronic otitis media]), with follow-up data collected until the end of 2017. Patients aged <15 years diagnosed with otitis media with effusion who received VT insertion were recruited at 15 tertiary hospitals. The primary outcomes were time to extrusion of VT, time to effusion recurrence, and complications. Results: . Data from 401 patients were analyzed. After excluding the results of long-lasting tubes (Paparella type II and T-tubes), silicone tubes (Paparella type I) exhibited a significantly longer extended time to extrusion (mean, 400 days) than titanium tubes (collar-button-type 1.0 mm: mean, 312 days; P<0.001). VT material (hazard ratio [HR], 2.117, 95% confidence interval [CI], 1.254–3.572; P=0.005), age (HR, 3.949; 95% CI, 1.239–12.590; P=0.02), and effusion composition (P=0.005) were significantly associated with the time to recurrence of middle ear effusion. Ears with purulent (mean, 567 days) and glue-like (mean, 588 days) effusions exhibited a shorter time to recurrence than ears with serous (mean, 846 days) or mucoid (mean, 925 days) effusions. The revision VT rates during follow-up were 3.5%, 15.5%, 10.4%, and 38.9% in ears with serous, mucoid, glue-like, and purulent effusions, respectively (P<0.001). The revision surgery rates were higher among patients aged <7 years than among those aged ≥7 years. Conclusion . Silicone tubes (Paparella type I) were less prone to early extrusion than titanium 1.0 mm tubes. VT type, patient age, and effusion composition affected the time to recurrence of effusion.