No Abstract Available.
Adenoma*

No abstract available.

PURPOSE: A papillary thyroid microcarcinoma (PTMC) measures 1 cm or less in diameter. The diagnosis, and thus the apparent incidence, of PTMC has recently increased owing to an increase in the detection of subclinical small and low-risk carcinomas with ultrasonography and fine needle aspiration cytology. However, central neck lymph node metastasis (CLNM) can occur in patients with PTMC. We evaluated the factors influencing CLNM in patients with PTMC. METHODS: We reviewed medical records including clinical information and pathologic reports, and analyzed 622 patients with PTMC who underwent thyroid surgery from January 2002 to December 2012. RESULTS: CLNM was detected in 119 patients (19.1%) of the 622 with PTMC. Lymph node metastasis occurred more frequently in males (P=0.025), and those with bilateral tumors (P=0.016), more than two tumors (P=0.035), tumor size greater than 5 mm (P<0.001), and lymphovascular invasion (P=0.024). There were no statistically significant differences in age and capsular invasion. Multivariate analysis showed that significant factors affecting lymph node metastasis included age at operation (odds ratio [OR]=0.647, 95% confidence interval [CI]=0.422∼0.990, P=0.045), sex (OR=0.489, 95% CI=0.268∼0.891, P=0.020), tumor size (OR=3.034, 95% CI=1.761∼5.224, P<0.001), and lymphovascular invasion (OR=15.036, 95% CI=1.450∼155.911, P=0.023). CONCLUSION: Age less than 45 years, male sex, tumor size greater than 5 mm, and lymphovascular invasion were risk factors associated with CLNM.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Humans ; Incidence ; Lymph Nodes* ; Male ; Medical Records ; Multivariate Analysis ; Neck* ; Neoplasm Metastasis* ; Risk Factors ; Thyroid Gland* ; Ultrasonography

PURPOSE: The purpose of this study was to evaluate the clinical outcomes and radiologic findings of primary total hip arthroplasty (THA) using cemented polished femoral stems. MATERIALS AND METHODS: We retrospectively reviewed 91 hips (91 patients) that had undergone primary THA with cemented polished femoral stems who were followed for at least 10 years. The mean age at surgery was 57 years (47-75 years). Mean follow up period was 12.8 years (10.1-14.0 years). Harris Hip Score (HHS) was used for clinical evaluation. Radiologic evaluation was focused on cementing technique including subsidence within the cement mantle, radiolucent lines at the cement-bone or cement-stem interface, cortical hypertrophy, and calcar resorption. RESULTS: The average HHS was 55.2 points before the surgery that improved to an average of 93.2 points at the final follow-up. According to Barrack classification, there were 50, 32, and 9 cases in A, B, and C grades, respectively. Subsidence of femoral stem was less than 2 mm except in one patient. There were no progressing radiolucent line or loosening of the femoral stem. CONCLUSION: In this study, THA using cemented polished femoral stems was found to have favorable outcomes in long term follow-up.
Arthroplasty, Replacement, Hip* ; Classification ; Follow-Up Studies ; Hip ; Humans ; Hypertrophy ; Methods ; Osteolysis ; Retrospective Studies

BACKGROUND: Capsaicin has been shown to have different biologic and toxic effects, depending on non-neuronal cells and several transformed cells, however no study has been reported from cultured human skin fibroblast. OBJECTIVE: Present study was aimed to evaluate the cytotoxicity and its mechanism of capsacin on the cultured human skin fibroblast. MATERIAL AND METHOD: Normal neonatal human fibroblasts were used, and changes of cell survival were measured by MTT assay after the cells were pre-treated with growth factors, receptor antagonist, antioxidants, calcium modulators were pre-treated or co-treated with capsaicin. RESULTS: Suvival of fibroblast was significantly increased by treatment with EGF (10ng/ml), bFGF (10ng/ml), capsazepine (10M) but inhibited by cycloheximide (1g/ml). When 200 M capsaicin was added to fibroblasts, chromatin condensations were observed at 12 hours and cell survival rate was reduced to 25-50% at 24 hours. Vanilloid receptor antagonists, capsazepine and ruthenium red, did not prevent the toxic effect of capsaicin, and 10M capsazepine paradoxically rather enhanced the cytotoxicity. In contrast to bFGF (10ng/ml), EGF (10, 100ng/ml) enhanced the cytotoxicity of capsaicin. Neuropeptides, substance P (1, 10nM) and CGRP (1, 10nM), and a structural analogue to capsaicin, tyrosine (0.3-1.2mM) did not affect the cytotoxicity. However, antioxidants such as trolox (100M) and ascorbic acid (0.1, 0.3 mM) reduced the capsaicin cytotoxicity. Of calcium modulating agents, nifedifine, a Ca2+ channel blocker (10, 20M) and cyclopiazonic acid, a Ca2+-ATPase inhibitor in ER (10M) did not influence the cytotoxicity, however BAPTA/AM (10M) as a chelater for cytoplasmic free calcium ion (10M) significantly decreased capsaicin cytotoxicity. Unlike cycloheximide, z-VAD-FMK, a protein synthesis inhibitor and a non-specific caspase inhibitor, prevented the capsaicin cytotoxicity. The DNA ladder and TUNEL positive cells were observed among the capsaicin treated fibroblasts and Western blot revealed caspase-3 activity. CONCLUSION: The capsaicin-induced cytotoxicity on human skin fibroblasts is likely to suggest the mechanism of an apoptotic pathway, which can possibly be prevented by antioxidants.
Antioxidants ; Ascorbic Acid ; Blotting, Western ; Calcium ; Capsaicin* ; Caspase 3 ; Cell Survival ; Chromatin ; Cycloheximide ; Cytoplasm ; DNA ; Epidermal Growth Factor ; Fibroblasts* ; Humans* ; In Situ Nick-End Labeling ; Intercellular Signaling Peptides and Proteins ; Neuropeptides ; Ruthenium Red ; Skin* ; Substance P ; Tyrosine

A 63-year-old woman had pronounced pincer nail of her big toenails. Her nail condition was markedly painful and associated with the underlying osteophyte. Under digital anaesthesia the nail plate was completely avulsed and the lateral portions of the matrix were destroyed by electrodessication. Then a longitudinal incision of the distal nail bed was made to separate it from the underlying structure and to expose the osteophyte. The exposed osteophyte was removed and the nail bed was sutured. Tie-under sutures were used to hold the bed in the appropriate transverse curvature. With this surgical correction, the treated nail showed a normal shape at 18 months of follow-up.
Female ; Follow-Up Studies ; Humans ; Middle Aged ; Nails ; Osteophyte* ; Sutures

PURPOSE: This study evaluated the results of acetabular medial wall osteotomy to reconstruct the acetabulum in dysplastic hip during total hip arthroplasty. MATERIALS AND METHODS: We clinically and radiologically evaluated 30 hips of 30 patients with secondary hip osteoarthritis caused by congenital hip dislocation or acetabular dysplasia who underwent total hip arthroplasty (THA) between March 1999 and October 2002. The average age of subjects was 46.5 years(17 to 73 years), and the mean follow-up period was 5 years(5.3 to 8.7 years). In 26 cases, a cementless hemispherical acetabular cup was inserted in the true acetabulum; in 4 cases a reinforced ring was inserted. Only 2 hips needed structural bone grafting. RESULTS: The average Harris hip score improved from 56.3 points preoperatively to 93.2 points at the last follow up. Radiographic analysis revealed no aseptic loosening or radiolucent line, and showed stable bony fixation at the true acetabulum. The mean thickness of the medial acetabular wall postoperative was 20.5 mm(10 to 36 mm). Bone union of the medial wall was observed at a mean of four months postoperatively. CONCLUSION: Acetabular medial wall osteotomy can maintain the integrity of the acetabular medial wall while achieving enhanced acetabular coverage and more normal hip biomechanics.
Acetabulum ; Arthroplasty ; Biomechanics ; Bone Transplantation ; Displacement (Psychology) ; Follow-Up Studies ; Hip ; Hip Dislocation, Congenital ; Humans ; Osteoarthritis, Hip ; Osteotomy

OBJECTIVE: To investigate the effect of the type of placenta and the portion of umbilical cord insertion on birthweight and growth discordancy in twin pregnancies. METHODS: We selected 120 twins of 146 multiple pregnancies between March, 2000 and March, 2002, and one fetus of all cases at least weighed 500 g or more and over 24 weeks of gestation. The fetuses were included that 44 twins (88 fetuses) had monochorionic placentas and the 76 twins (152 fetuses) had dichorionic placentas. The dichorionic twins were divided into two groups; one (38 twins, 76 fetuses) showed the fused type of placenta and the other (38 twins, 76 fetuses) showed the separate type of placenta. The types of umbilical cord insertion were also divided into the central portion and the peripheral portion, the peripheral portion was defined within 2 cm of margin of placenta, and included marginal and velamentous insertion of umbilical cord. Stastical analysis were performed with Student t-test and runs test. p<0.05 was defined significantly. RESULTS: 1. The central type of umbilical cord insertion in dichorionic placenta was more frequent than that of monochorionic placenta (p<0.01). 2. The dichorionic infants, regardless the number of placenta, who weighed more than monochorionic infants at birth (p<0.01). 3. Twin pairs with over 25% of growth discordancy were 16 cases (13.3%), which included 9 cases (9/76, 11.8%) of dichorionic placenta and 7 cases (7/44, 15.9%) of monochorionic placenta. The severe growth discordancy was more commonly developed in monochorionic twins than dichorionic twins (p<0.01). 4. Perinatal deaths in twin pairs with over 25% of GD were 12 cases, which included 3 cases (3/18, 16.7%) of dichorions, and 9 cases (9/14, 64.3%) of monochorions. Therefore, perinatal death was showed more commonly in monochorinic twin infants (p<0.01). CONCLUSION: The type of umbilical cord insertion affected the birthweight of dichorionic separated infants. Monochorionic placenta attributed to more severe growth discordancy and increased perinatal death rate than the dichorionic placenta. Antenatal detection of chorionicity and the portion of umbilical cord insertion may improve the perinatal outcome.
Chorion ; Female ; Fetus ; Humans ; Infant ; Mortality ; Parturition ; Placenta* ; Pregnancy ; Pregnancy, Multiple ; Pregnancy, Twin* ; Umbilical Cord*

BACKGROUND: Nalbuphine is one of the opioid agonist-antagonists and is used frequently in the anesthetic field. Usage is focused on potent analgesic action and the adjuvant of narcotics because of less complications with preserved analgesia. The most common routes of administration for postoperative pain control are epidural and intravenous, so we compared both pharmacokinetic profiles. METHODS: Twelve patients were randomly divided into two groups. All patients were given a spinal anesthesia with tetracaine hydrochloride. One group (n = 6) received nalbuphine 10 mg via epidural route and another group (n = 6) received the same dose via intravenous route. Venous blood was drawn at 0, 0.25, 0.5, 1, 2, 4, 6 and 8 hours to measure plasma nalbuphine concentrations. Analysis was performed by high performance liquid chromatography with an electrochemical detector. RESULTS: At 0.25 hour, the plasma concentration of nalbuphine was significantly higher in the epidural administration group (49.48 +/- 4.98 ng/ml) than in the intravenous administration group (40.44 +/- 1.64 ng/ml). At 6 and 8 hours, the plasma concentration of nalbuphine was significantly higher in the epidural administration group (5.98 +/- 1.86 ng/ml, 3.85 +/- 0.94 ng/ml) than in the intravenous administration group (3.80 +/- 0.33 ng/ml, 2.43 +/- 0.32 ng/ml). Clearance, elimination half life, volume of distribution and AUC were not significantly different between the two groups. CONCLUSIONS: The plasma concentrations of nalbuphine via epidural route and intravenous route were similar in both groups after 0.25 hour to 6 hours. At 0.25 hour and after 6 hours, the epidural administration group had a higher plasma concentration of nalbuphine than the intravenous administration group.
Administration, Intravenous* ; Analgesia ; Anesthesia, Spinal ; Area Under Curve ; Chromatography, Liquid ; Half-Life ; Humans ; Nalbuphine* ; Narcotics ; Pain, Postoperative ; Plasma* ; Tetracaine

OBJECTIVES: An association between serum cholesterol concentration and violent behavior has been suggested, but has not been consistently demonstrated. This study was conducted in oreder to evaluate the relation between serum cholesterol concentration and violent behavior in psychiatric inpatients who had been admitted at Uijongbu St.Mary's Hospital, the Catholic University of Korea from January 1994 to June 1995. METHODS: We divided the 127 subjects into violent(35 subjects) and non-violent group(95 subjects). According to the percentile distribution of serum total cholesterol in healthy Korean adults, the subjects were classified into four subgroups:Group 1,subjects whose cholesterol concentrations were below 26% of percentile distribution, Group 2,from 26% to 50%, group 3, 51% to 75% and group 4, above 75%. In the four cholesterol subgroups, the authors examined the incidence of violent behaviors and suicidal attempts. Within the violent group, total aggression score of four cholesterol subgroups was compared. RESULTS: 1) Among the four cholesterol subgroups, there were no significant differences in the violent behavior. 2) within the violent groups, total violent score of the four cholesterol subgroups showed no significant difference. 3) Among the four cholesterol subgroups, there were no significant differences in suicidal attempt. CONCLUSION: When the serum cholesterol concentrations of psychiatric inpatient applied to the percentile distribution of serum total cholesterol in healthy Korean adult, no association was found between serum cholesterol concentration and violent behavior and suicide attempt.
Adult ; Aggression ; Cholesterol* ; Humans ; Incidence ; Inpatients* ; Korea ; Suicide