No abstract available.
Bone Substitutes* ; Polyethylene*

After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.
Head* ; Humeral Fractures ; Humerus* ; Incidence ; Intra-Articular Fractures ; Surgeons ; Ulnar Nerve*

Pseudohypoparathyroidism is a medical disorder characterized by a complex disorder of renal resistance to parathyroid hormone and the mechanism underlying the disease is still unclear. The authors described two cases of pseudohypoparathyroidism in sibling,who had metabolic anomalies(hypocalcemia and hyperphosphatemia, high circulatin immunoreactive PTH)and basal ganglia calcification. Bilateral basal ganglia calcifications, which was not visible on plain skull film, was detected by CT scan of brain MRI. We report these cases with a review of related literatures.
Basal Ganglia ; Brain ; Humans ; Hyperphosphatemia ; Magnetic Resonance Imaging ; Parathyroid Hormone ; Pseudohypoparathyroidism* ; Siblings* ; Skull ; Tomography, X-Ray Computed

Scrotal leiomyosarcoma arising from dartos layer not involving the testis, epididymis or spermatic cord is very rare tumor. We report a case of scrotal leiomyosarcoma in 29 year old man who present with right scrotal painless growing mass. The lesion had been for 3 months but there was no related symptom such as pain or tenderness. The excised lesion was 3 x 3cm sized ovoid mass with smooth surface and it had no relationship with the testis, epididymis and spermatic cord. Its pathologic finding was compatible with leiomyosarcoma. So additional radical orchiectomy was done.
Adult ; Epididymis ; Humans ; Leiomyosarcoma* ; Male ; Orchiectomy ; Scrotum* ; Spermatic Cord ; Testis

PURPOSE: To determine the upper limit of peripheral nerve lengthening without loss of function, the recovery time of peripheral nerve palsy due to nerve lengthening and their histological changes. MATERIALS AND METHODS: Twelve adult New Zealand rabbits weighing about 2.5 kg were assigned to the following groups. Group 1 (n=6) was subjected to slow tissue expansion with 30% of nerve lengthening while group 2 (n=6) was rapid expansion with 40% lengthening of nerve. The expanders were refilled every 2 times during the 2nd and 4th weeks making a total four times of expansion. The rabbits were assessed in terms of affected leg paralysis, neural length gain, EMG with nerve conduction velocity and histological changes. RESULTS: In group 1 (n=6), paralysis on affected leg was found in one rabbit and was recovered spontaneously on the 4th weeks after expander removal. In Group 2 (n=6), paralysis was found in four rabbits, and three of them were recovered on 4, 5 and 9 weeks after removal of the expander. EMG study showed increase in distal latency of 2.50+/- 0.20 m/sec, and decrease in nerve conduction velocity of 62.49+/- 5.30 m/sec compared to normal side with 1.89+/- 0.14 m/sec and 75.39+/- 7.82 m/sec. The mean neural length gain was 6 mm (30% of 20 mm of initial pre-experimental nerve length) in group 1 and 8 mm (40% of 20 mm) in group 2. Light microscopic examination revealed the loss of segmental myelination, decrease of myelination, and vacuolation. Electron microscopic examination showed that the normal ring shaped contour of axon was changed to convoluted shape.
Adult ; Axons ; Humans ; Leg ; Myelin Sheath ; Nerve Expansion ; Neural Conduction ; Paralysis ; Peripheral Nerves ; Rabbits ; Sciatic Nerve* ; Tissue Expansion*

BACKGROUND: Medical interviewing skills are now recognized as the most important skill to be acquired for the purpose of accurate diagnosis and treatment. Among the several evaluation methods of interviewing skills, audiovisual method has the merit of allowing the fellow residents to have discussion about the interview and of receiving feedback from the teaching faculty by replaying the real interview. In addition, it allows the resident to evaluate his or her interviewing skills, The purpose of this study is to evaluate the reliability and the validity of family residents' self-interviewing skill evaluation protocol. METHODS: A modified arizona interview rating scale which is an interviewing skill evaluating protocol has been used after Korean version became available. Six interviews with outpatients were recorded and evaluated respectively by 10 residents. The results were compared with that of Golden Standard to assess its validity. Finally, 10 residents were divided into two groups and the results among the groups were compared to evaluate the reliability of the scale. RESULTS: The evaluation of interviewing skills conducted by the residents showed significant rate of correspondence with the Golden Standard(kappa=.22), and in the comparison of 17 evaluation items, there appeared significant correspondence in 7 items. The analysis of the rate of correspondence between the two group of residents revealed significant rate of correspondence (kappa=0.43). Lastly, the comparisons between the items showed significant rate of correspondence in ll items CONCLUSIONS: The residents' self interviewing skill evaluation protocol showed significant validity and reliability from which it may be concluded that the protocol can be used as an effective evaluating method.
Arizona ; Diagnosis ; Diagnostic Self Evaluation ; Humans ; Outpatients ; Reproducibility of Results*

After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.
Head ; Humeral Fractures ; Humerus ; Incidence ; Intra-Articular Fractures ; Surgeons ; Ulnar Nerve

We report here on an uncommon case of peliosis hepatis with hemorrhagic necrosis that was complicated by massive intrahepatic bleeding and rupture, and treated by emergent right lobectomy. We demonstrate the imaging findings, with emphasis on the triphasic, contrast-enhanced multidetector CT findings, as well as reporting the clinical outcome in a case of peliosis hepatis with fatal hemorrhage.
Tomography, X-Ray Computed/*methods ; Rupture ; Peliosis Hepatis/complications/*radiography/surgery ; Necrosis ; Humans ; Hemorrhage/etiology/*radiography/surgery ; Female ; Adult

We have previously isolated a novel protein "B/K" that contains two C2-like domains. Here, we report the isolatioin and mRNA distribution of a human B/K isoform, and protein kinase A (PKA)-dependent phosphorylation of the B/K protein. The 1.5 kb human B/K cDNA clone exhibits 89% and 97% identities with rat B/K in the sequences of nucleotide and amino acid, respectively. Human B/K isoform encodes a 474 amino acid protein and shows structural features similar to the rat counterpart including two C2 domains, three consensus sequences for PKA, absence of a transmembrane region, and conservation of the N-terminal cysteine cluster. On Northern and dot blot analyses, a 3.0 kb B/K transcript was abundantly present in human brain, kidney, and prostate. Among the brain regions, strong signals were observed in the frontal and temporal lobes, the hippocampus, the hypothalamus, the amygdala, the substantia nigra, and the pituitary. Recombinant B/K proteins containing three consensus sites for PKA was very efficiently phosphorylated in vitro by PKA catalytic subunit. B/K protein which was overexpressed in LLC-PK1 cells was also strongly phosphorylated in vivo by vasopressin analog DDAVP, and PKA-specific inhibitor H89 as well as type 2 vasopressin receptor antagonist specifically suppressed DDAVP-induced B/K phosphorylation. These results suggest that B/K proteins play a role as potential substrates for PKA in the area where they are expressed.
Sequence Homology, Amino Acid ; Sequence Analysis, DNA ; Rats ; Protein Isoforms/genetics ; Phosphorylation ; Phosphoproteins/genetics/*metabolism ; Molecular Sequence Data ; Mice ; Male ; Humans ; Gene Expression Profiling ; Female ; DNA, Complementary/chemistry/genetics ; Cyclic AMP-Dependent Protein Kinases/*physiology ; Cloning, Molecular ; Cell Line ; Base Sequence ; Animals ; Amino Acid Sequence ; Adult

Human toxocariasis is the most prevalent helminthiasis in Korea and other industrialized countries. The clinical features of toxocariasis are diverse, according to the involved organ. Typically, Toxocara spp. infection is easily treated with 400 mg albendazole twice a day for 5 days. However, we experienced a case of recurrent toxocariasis that was refractory to this standard therapy and presented with urticaria, an uncommon symptom in toxocariasis. A 35-year-old male visited our emergency room because of abdominal pain. He had recently consumed raw cow liver (3 weeks prior to presentation). Laboratory analyses revealed eosinophilia (1,612 cells/microliter) and increased total IgE (3,060 IU/mL). Chest X-ray showed multiple lung nodules in both lungs, and computed tomography revealed multiple ground-glass opacities in both lungs and multiple tiny liver abscesses. Liver biopsy revealed an eosinophilic abscess. Enzyme-linked immunosorbent assay findings for Toxocara antigens were positive (optical density, 2.140), leading to a diagnosis of toxocariasis. We initiated a 5-day treatment with albendazole and prednisolone; however, 6 days after completing the treatment, the patient again experienced urticaria and severe itching that could not be controlled by antihistamines or hydrocortisone cream. A second bout of eosinophilia suggested recurring toxocariasis, for which we prescribed a second round of albendazole. Despite an initial improvement in his symptoms, the patient returned after 6 weeks complaining of abdominal pain for 6 hours, which was reminiscent of his first attack; he also exhibited eosinophilia. Accordingly, albendazole was administered once more for an additional 3 weeks, and his symptoms resolved.
Abdominal Pain ; Abscess ; Adult ; Albendazole ; Biopsy ; Developed Countries ; Emergencies ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Helminthiasis ; Histamine Antagonists ; Humans ; Hydrocortisone ; Immunoglobulin E ; Korea ; Liver ; Liver Abscess ; Lung ; Male ; Pruritus ; Thorax ; Toxocara ; Toxocariasis ; Urticaria