Neither the cause nor the correct treatment of Kienbocks disease has been clearly established, but its clinical and radiologic presentations have been distinctly defined. There are many controversies concerning therapeutic guidelines for the treatment of Kienbocks disease. The purpose of this study is to evaluate the clinical result of triscaphe fusion with radial styloidectomy of Kienbocks disease. Ten cases of stage III Kienbocks disease by Lichtmans classification were treated by triscaphe fusion with radial styloidectomy from September 1991 to March 1997. We followed up over 24 months and evaluated clinical results. In all cases, pain was relieved. The postoperative results according to Kuschners method revealed three excellent, six good and one fair. The triscaphe fusion and radial styloidectomy was considered as useful method of treatment which has clinical efficacy in Kienbocks disease.
Classification ; Osteonecrosis*

PURPOSE: Laparoscopic colectomy is technically demanding. Here we share of experience with laparoscopic procedures with focusing on (1) preoperative localization by a colonoscopic tattoo and (2) comparing the laparoscopic total mesorectal excision (lapaTME) with the conventional TME (openTME) according to microscopic examination. METHODS: We retrospectively collected 112 cases of laparoscopic colectomy that was performed for treating colorectal cancer during the past 6 years. Preoperative colonoscopic tattoo was done by using india ink. The tattoo cases were compared with the non-tattoo cases. Comparison between 13 cases of lapaTME and 15 cases of openTME was assessed by both gross and microscopic examination in the 28 cases for 9 months. The lapaTME and openTME were applied to mid-rectal cancer and mid&low rectal cancer, respectively. RESULTS: Tattoo was carried out for the Tis (100%), T1 (92%), T2 (72%), T3 (36%) cases. Of the significant cases, T3 lesion was not identified at laparoscopic colectomy. LapaTME grossly showed a greater incidence of defect than that of openTME, but there was no difference microscopically between lapaTME and openTME. CONCLUSION: A tattoo was useful for early lesion and it should be considered for advanced lesion. LapaTME for mid-rectal cancer can be done without compromising the principles of TME.
Carbon ; Colectomy ; Colorectal Neoplasms ; Incidence ; India ; Ink ; Laparoscopy ; Rectal Neoplasms ; Retrospective Studies

Although extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) has emerged as a significant community-acquired pathogen, there is little epidemiological information regarding community-onset bacteremia due to ESBL-EC. A retrospective observational study from 2006 through 2011 was performed to evaluate the epidemiology of community-onset bacteremia caused by ESBL-EC. In a six-year period, the proportion of ESBL-EC responsible for causing community-onset bacteremia had increased significantly, from 3.6% in 2006 to 14.3%, in 2011. Of the 97 clinically evaluable cases with ESBL-EC bacteremia, 32 (33.0%) were further classified as healthcare-associated infections. The most common site of infection was urinary tract infection (n=35, 36.1%), followed by biliary tract infections (n=29, 29.9%). Of the 103 ESBL-EC isolates, 43 (41.7%) produced CTX-M-14 and 36 (35.0%) produced CTX-M-15. In the multilocus sequence typing (MLST) analysis of 76 isolates with CTX-M-14 or -15 type ESBLs, the most prevalent sequence type (ST) was ST131 (n=15, 19.7%), followed by ST405 (n=12, 15.8%) and ST648 (n=8, 10.5%). No significant differences in clinical features were found in the ST131 group versus the other group. These findings suggest that epidemic ESBL-EC clones such as CTX-M-14 or -15 type ESBLs and ST131 have disseminated in community-onset infections, even in bloodstream infections, which are the most serious type of infection.
Aging ; Bacteremia/drug therapy/*epidemiology ; Biliary Tract Diseases/epidemiology/microbiology ; Cephalosporin Resistance/genetics ; Cephalosporins/therapeutic use ; Community-Acquired Infections/*epidemiology/microbiology ; Escherichia coli/isolation & purification/metabolism ; Escherichia coli Infections/drug therapy/*epidemiology ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Multilocus Sequence Typing ; Prevalence ; Retrospective Studies ; Urinary Tract Infections/epidemiology/microbiology ; beta-Lactamases/*metabolism

PURPOSE: This study was conducted to evaluate the effectiveness of the treatment strategy of transcatheter arterial embolization after pelvic CT angiography (CTA) in cases of traumatic pelvic hemorrhage. METHODS: This is a retrospective analysis of pelvic hemorrhage patients who underwent transcatheter arterial embolization after pelvic CTA at our regional emergency center during a 31-month period. We reviewed the medical records and imagings of all these patients. RESULTS: Transcatheter arterial embolization was performed in 17 patients (M:F=7:10, mean age=53.9) who underwent pelvic CTA for the evaluation of traumatic pelvic hemorrhage. Arterial bleeding was demonstrated on pelvic CTA in all patients, and the combined injury was also noted in 13 patients. The admission-to-CTA time was 84.53+/-66.92 minutes, and the CTA-to-embolization time was 147.65+/-99.97 minutes. Extravasation of contrast media or pseudoaneurysm was demonstrated on conventional angiography in all patients. Unilateral iliac artery embolization was performed in 8 patients, and bilateral iliac artery embolization was performed in 9 patients. Additional embolizations other than in the iliac arteries were performed in 7 patients. Initial hemostasis was achieved in 16 patients. One patient died of ongoing pelvic bleeding. Rebleeding occurred in only one patient and hemostasis was achieved with the second embolization. Another patient died of intracranial and facial bleeding in spite of pelvic hemostasis. The overall mortality was 11.8%, and there was no significant adverse effects in the other patients. CONCLUSION: Transcatheter arterial embolization after pelvic CTA is an effective treatment strategy in the management of traumatic pelvic hemorrhage patients.
Aneurysm, False ; Angiography ; Embolization, Therapeutic ; Emergencies ; Extravasation of Diagnostic and Therapeutic Materials ; Hemorrhage ; Hemostasis ; Humans ; Iliac Artery ; Medical Records ; Pelvis ; Retrospective Studies

PURPOSE: To determine which contrast media are both efficient and safe for the imaging of airways. MATERIALS AND METHODS: We evaluated five contrast media (barium, gastrografin, iotrolan, ioxaglate, iopentol) in terms of image quality and their effects on the lungs of 25 white rabbits. For bronchography 0.5ml of contrast media was used. In each contrast group, HRCT scans were obtained immediately (n=5), 12 hours (n=4), 1 day (n=3), 2 days (n=2), and 1 week (n=1) after bronchography. Histopathologic specimens were obtained immediately, 12 hours, 1 day, 2 days, and 1 week later. Bronchograms were evaluated for image quality by three radiologists working independently, and were scored as 1(poor), 2(moderate), or 3(good) in terms of contrast quality and bronchial coating. HRCT was evaluated by two radiologists who reached a concensus; they determined the presence of contrast media, and then the pattern and extent of pulmonary opacity, and any related changes. Histopatholgic specimens were evaluated by two pathologists who sought consensus as to the extent of inflammation, pulmonary edema, and hemorrhage, and any changes in these aspects. RESULTS: Bronchography indicated that the sum of scores for contrast quality was 45 for barium, 33 for gastrografin, 28 for iotrolan, 30 for ioxaglate, and 28 for iopentol, while for each of these media, the sum of scores for bronchial coating was 39, 19, 25, 23, and 21, respectively. Barium showed the best image quality. In all rabbits, HRCT demonstrated the variable extent of groundglass attenuation and/or consolidation. Lesions were most extensive at 1-2 days and then regressed at 1 week; these HRCT findings correlated well with histologic findings. In histologic studies of all five contrast media groups, variable severe inflammatory reactions were observed, with or without necrosis, congestion, edema, and hemorrhage. It was noted that ioxaglate appeared to cause least tissue reaction. CONCLUSIONS: The imaging results of this experimental study indicate that for bronchography, barium is the best available contrast media, On the basis of the histologic and HRCT results, however, ioxaglate is the best.
Barium ; Bronchography* ; Consensus ; Contrast Media* ; Diatrizoate Meglumine ; Edema ; Estrogens, Conjugated (USP) ; Hemorrhage ; Ioxaglic Acid ; Lung ; Necrosis ; Pneumonia ; Rabbits

The prognosis of lung cancer is very poor. Patients with lung cancer have usually no symptom in early stage or some mild cough, sputum. When patient feel weight loss or dyspnea, majority of patients with lung cancer are advanced stage and inoperable. The growth rate of lung cancer is different according to cell type of tumor and related to prognosis. Generally, tumor. doubling time (TDT) of lung cancer has been known that small cell lung cancer is about 65 days, squamous cell carcinoma is about 90 days, and adenocarcinoma is about 185 days. There has been rarely reported of lung cancer with very fast or very slow growth. The prognosis of a slow growing lung cancer is relatively good but rapidly growing cancer is not. We report a very rare case that surgicallytreated early stage non-small cell lung cancer (adenocarcinoma) with 4-year- TDT without invasion or distant metastasis
Adenocarcinoma* ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cough ; Dyspnea ; Humans ; Lung Neoplasms ; Lung* ; Neoplasm Metastasis ; Prognosis ; Small Cell Lung Carcinoma ; Sputum ; Weight Loss

OBJECTIVE: This study examined the effect of social support on metabolic syndrome (MetS) among elderly population in a city in Korea. METHODS: A total of 352 people all over 60 years of age were analyzed from the data of the Korean Longitudinal Study on Cognitive Aging and Dementia. This study was started in 2010 and is in progress till date. We compared the documented diagnoses of MetS and Medical Outcome Study Social Support Survey at the baseline of the study and two years later. RESULTS: 315 were normal, 37 were developed after two years among subjects without MetS at baseline. When the level of social support was compared at baseline and then at the time of the reassessment two years later, the level had increased in the normal group and the level had not significantly changed for the MetS group. The findings documented at the two year mark indicate that the higher and stronger the level of social support, the lower the risk of developing MetS (odds ratio=0.053, p=0.040). CONCLUSION: The elderly with good social support are noted to be at lower risk in developing MetS as opposed to those with poor social support. It is apparent that adequate social support shows reduced prevalence of MetS among the elderly. Methods to identify strategies in improving social support networks are needed to expand public health resources and to better accommodate the community-based care of the elderly.
Aged* ; Cognitive Aging ; Dementia ; Diagnosis ; Humans ; Korea* ; Longitudinal Studies ; Outcome Assessment (Health Care) ; Prevalence ; Public Health

Peripheral polyneuropathy is caused by various disorders such as diabetes mellitus. Cryoglobulinemia, as a cause of peripheral polyneuropathy, has been well documented in many reports. Recently we experienced a case of essential cyroglobulinemic polyneuropathy and therapeutic effect of plasmapheresis was shown even in chronic periods. In a patient with peripheral polyneuropathy with no known etiology, one should always consider cryoglobulinemia as a cause since early diagnosis and proper treatment will lead to better outcome.
Cryoglobulinemia ; Diabetes Mellitus ; Early Diagnosis ; Humans ; Plasmapheresis ; Polyneuropathies

PURPOSE: Nuclear Factor-kappaB p65 (NF-kappaB p65) and nuclear Factor-kappaB1 p50 (NF-kappaB p65) have been shown to play roles in cell proliferation, apoptosis, cytokine production and oncogenesis. This study was designed to investigate the expressions of NF-kappaB p65 and NF-kappaB p50 proteins in premalignant lesions and colorectal adenocarcinoma. METHODS: Paraffin sections of 20 normal mucosa specimens, 20 low grade tubular adenoma specimens, 20 high grade tubular adenoma specimens and 64 adenocarcinoma specimens were analyzed immunohistochemically for the expressions of NF-kappaB p65 and NF-kappaB p50 proteins. RESULTS: The expressions of NF-kappaB p65 and NF-kappaB p50 proteins were significantly higher in the adenocarcinoma tissue compared with that in the normal mucosa, the low grade tubular adenoma and the high grade tubular adenoma tissues. The frequency of a NF-kappaB p50 expression was higher in the poorly differentiated histologic grade specimens, in the presence of nodal metastasis and in the high stage specimens. There were significant correlations between the NF-kappaB p65 and NF-kappaB p50 proteins. CONCLUSION: The expressions of NF-kappaB p65 and NF-kappaB p50 proteins may play a role in the pathogenesis of colorectal carcinoma.
Adenocarcinoma ; Adenoma ; Apoptosis ; Cell Proliferation ; Cell Transformation, Neoplastic ; Colorectal Neoplasms ; Mucous Membrane ; Neoplasm Metastasis ; NF-kappa B ; Paraffin ; Proteins