Endcap placement after intramedullary nailing can be cumbersome. Misplacement of the endcap which may be difficult to extract may occur. In this report, a simple Kirschner wire device with 'fish-hook' technique may ease the procedure without further violating bony or soft tissues.
Fracture Fixation, Intramedullary* ; Tibia*

Premature menopause can be developed as a result of undesired nontarget ovary embolization during the performance of uterine fibroid embolization. The etiology of ovarian failure after uterine fibroid embolization is not yet clearly defined, but one of the leading possibilities is nontarget embolization of the ovaries. We report here on two cases in which superselective coil embolization of distal uterine artery collateral pathways to the ovary was performed during uterine fibroid embolization.
Angiography ; Embolization, Therapeutic* ; Female ; Leiomyoma* ; Menopause, Premature ; Ovary ; Uterine Artery ; Uterus

Premature menopause can be developed as a result of undesired nontarget ovary embolization during the performance of uterine fibroid embolization. The etiology of ovarian failure after uterine fibroid embolization is not yet clearly defined, but one of the leading possibilities is nontarget embolization of the ovaries. We report here on two cases in which superselective coil embolization of distal uterine artery collateral pathways to the ovary was performed during uterine fibroid embolization.
Angiography ; Embolization, Therapeutic* ; Female ; Leiomyoma* ; Menopause, Premature ; Ovary ; Uterine Artery ; Uterus

PURPOSE: We wanted to review the clinical results of staged reimplantation in patients who had candidal infection after total knee arthroplasty. MATERIALS AND METHODS: We reviewed five patients who had a candidal prosthetic knee infection, as was assessed by synovial fluid culture. Amphotericin B was intravenously administrated to all five patients during the postoperative period for six weeks and followed for at least twelve months. We carried out two-stage re-implantations with using antifungal agent-impregnated bone cement. Whether or not infection recurred was evaluated according to the symptoms and radiologic and hematologic studies. The clinical results were analyzed on the basis of the range of motion and hospital for special surgery (HSS) score. RESULTS: The final review showed that all of the symptoms disappeared. We could not find any loosening on the radiologic studies and all five patients had normal C-reactive protein values on serological exams. The mean postoperative range of motion was 1degrees (range: 0~5)~99degrees (range: 70~130) and the mean HSS score improved from 49.4 (range: 44~64) points to 73 (range: 65~90) after the re-implantation. CONCLUSION: We successfully controlled five candidal prosthetic knee infections by removing the components in conjunction with using an antifungal- impregnated bone cement and staged re-implantation after a 6 week course of intravenous antifungal drugs.
Amphotericin B ; Arthroplasty ; C-Reactive Protein ; Candida ; Humans ; Knee ; Postoperative Period ; Range of Motion, Articular ; Replantation ; Synovial Fluid

Papillary thyroid carcinoma is the most prevalent type of thyroid cancer. Metastasis of this carcinoma commonly occurs in the lung and has been reported to present 5 to 30 years after the initial diagnosis of thyroid cancer. Pleural effusion can mask this metastatic spread. In patients with pleural effusion, laboratory measurement of the adenosine deaminase (ADA) level in the pleural fluid can be effective in identifying and ranking pulmonary metastasis in the differential diagnosis. A 70-year-old female patient visited our hospital with dyspnea. She presented with a considerable amount of pleural effusion. A pleural biopsy was performed and the Ziehl-Neelsen stains revealed a few acid-fast bacilli, but the ADA level in the pleural fluid was 2.4 IU/L. After drainage of the pleural effusions, we discovered pulmonary nodules by computed tomography (CT), which were later diagnosed through histologic examination as pulmonary metastasis from papillary thyroid carcinoma. We report this case.
Adenosine Deaminase ; Aged ; Biopsy ; Carcinoma ; Carcinoma, Papillary ; Coloring Agents ; Drainage ; Dyspnea ; Female ; Humans ; Lung ; Masks ; Neoplasm Metastasis ; Pleural Effusion ; Pleurisy ; Thyroid Gland ; Thyroid Neoplasms ; Tuberculosis, Pleural

PURPOSE: To assess the usefulness of the Hounsfield number, measured by a non-contrast enhanced pelvic CT, after a uterine artery embolization as an index of the successful outcome of a uterine fibroid embolization (UFE). MATERIALS AND METHODS: The study subjects included 15 women (age range: 28-49 years, mean age: 36.4 years) diagnosed with symptomatic uterine myomas and seen from March 2003 to August 2005. A non-contrast enhanced pelvic CT scan was performed six hours after a uterine artery embolization. The global and maximal CT numbers were measured for each myoma. In addition, a pelvic MRI was performed to measure the volume of each myoma prior to and 6 months after the UFE. The relationship between fibroid volume reduction and the global CT number were prospectively analysed. RESULTS: The mean global CT number was 91.25 HU in Group I and 40.8 HU in Group II. Further, the mean fibroid volume reduction rate was 73% in Group I and 10% in Group II (p < 0.05). CONCLUSION: The global CT number measured by a non-contrast enhanced pelvic CT is a useful predictive factor of a successful uterine fibroid embolization.
Embolization, Therapeutic ; Female ; Humans ; Leiomyoma ; Myoma ; Prospective Studies ; Radiology, Interventional ; Tomography, X-Ray Computed ; Uterine Artery Embolization ; Uterine Neoplasms

PURPOSE: This study examined the value and indications of repeated MRI in degenerative lumbar diseases under conservative management by comparing the primary MR and repeated MR images with respect to the symptomatic and radiological changes. MATERIALS AND METHODS: Seventy patients with degenerative lumbar disease under conservative management underwent repeat MRI. Five MRI findings, including disc, foramen, facet joint, nerve root, and ligamentum flavum, were used to examine the difference between the initial and repeat MRI. The severity was graded using a four-point scale for each item. The patients were divided into 3 groups in order to compare the radiological changes and symptomatic changes, as follows; Group I no change from the initial symptoms (38 cases), Group II aggravation of the initial pain (18 cases), and Group III aggravation of the initial neurology or the development of a new neurology (14 cases). RESULTS: The mean scores of each item the disc, foramen, facet joint, nerve root and ligamentum flavum increased from 1.76, 1.31-1.79, 1.71, and 1.47, respectively, to 1.90, 1.47, 1.80, 1.79, and 1.53, respectively. Group III showed the greatest proportion of cases with an increasing grading score (78%, 11 cases) only the disc was significant. CONCLUSION: Repeat MRI in degenerative lumbar disease under conservative management was found to be valuable only in cases with aggravated neurological symptoms, and was not relevant in cases with persistent symptoms or aggravated pain alone.
Humans ; Ligamentum Flavum ; Neurology ; Zygapophyseal Joint

The interaction of mating pheromone and pheromone receptor from the B mating-type locus is the first step in the activation of the mushroom mating signal transduction pathway.The B mating-type locus of Lentinula edodes is composed of Bα and Bβ subloci, each of which contains genes for mating pheromone and pheromone receptor. Allelic variations in both subloci generate multiple B mating-types through which L. edodes maintains genetic diversity. In addition to the B mating-type locus, our genomic sequence analysis revealed the presence of a novel chromosomal locus 43.3 kb away from the B mating-type locus, containing genes for a pair of mating pheromones (LPHBN1 and PHBN2) and a pheromone receptor (RCBN). The new locus (Bα-N) was homologous to the Bα sublocus, but unlike the multiallelic Bα sublocus, it was highly conserved across the wild and cultivated strains. The interactions of RcbN with various mating pheromones from the B and Bα-N mating-type loci were investigated using yeast model that replaced endogenous yeast mating pheromone receptor STE2 with RCBN. The yeast mating signal transduction pathway was only activated in the presence of PHBN1 or PHBN2 in the RcbN producing yeast, indicating that RcbN interacts with self-pheromones (PHBN1 and PHBN2), not with pheromones from the B matingtype locus. The biological function of the Bα-N locus was suggested to control the expression of A mating-type genes, as evidenced by the increased expression of two A-genes HD1 and HD2 upon the treatment of synthetic PHBN1 and PHBN2 peptides to the monokaryotic strain of L. edodes.

BACKGROUND: The study of pneumonia among young men living in a group is rare. prospective study was conducted to determine the etiology, and compare the effects of macrolide and second-generation cephalosporin on the treatment of pneumonia among combat policemen. PATIENTS AND METHODS: From January 2003 to April 2004, Fifty-two patients with pneumonia were treated with either azithromycin(n=25) or cefuroxime(n=27). In order to determine the cause of the pneumonia, culture studies and serologic tests for antibodies to Mycoplasma pneumoniae and Chlamydia pneumoniae were carried out. During the two weeks of medication, the Chest X-rays, blood tests and culture studies(if necessary) were followed weekly. A serologic study was followed at the end of the second week. RESULTS: The main pathogens for pneumonia among combat policemen were Mycoplasma pneumoniae(50.0%), Chlamydia pneumoniae(10.8%), and Streptococcus pneumoniae(3.8%). The treatment was successful in most cases(51/52 cases, 98.1%). The effects of azithromycin and cefuroxime were similar (96.0% vs 100%, p>5). In one patient who had taken azithromycin, the clinical and radiological findings did not improved until intravenous second generation ce?phalosporin had been infused. CONCLUSION: Atypical pathogens were the main causes of the pneumonia in the combat policemen, and the effects of macrolide and second generation cephalosporin for pneumonia were similar. However, further studies will be needed to determine if single therapy with macrolide is possible.
Antibodies ; Azithromycin ; Cefuroxime ; Cephalosporins ; Chlamydia ; Chlamydophila pneumoniae ; Hematologic Tests ; Humans ; Macrolides ; Male ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia* ; Pneumonia, Mycoplasma ; Prospective Studies* ; Serologic Tests ; Streptococcus ; Thorax

BACKGROUND/AIMS: A revised classification system for renal dysfunction in patients with cirrhosis was proposed by the Acute Dialysis Quality Initiative and the International Ascites Club Working Group in 2011. The aim of this study was to determine the prevalence of renal dysfunction according to the criteria in this proposal. METHODS: The medical records of cirrhotic patients who were admitted to Konkuk University Hospital between 2006 and 2010 were reviewed retrospectively. The data obtained at first admission were collected. Acute kidney injury (AKI) and chronic kidney disease (CKD) were defined using the proposed diagnostic criteria of kidney dysfunction in cirrhosis. RESULTS: Six hundred and forty-three patients were admitted, of whom 190 (29.5%), 273 (42.5%), and 180 (28.0%) were Child-Pugh class A, B, and C, respectively. Eighty-three patients (12.9%) were diagnosed with AKI, the most common cause for which was dehydration (30 patients). Three patients had hepatorenal syndrome type 1 and 26 patients had prerenal-type AKI caused by volume deficiency after variceal bleeding. In addition, 22 patients (3.4%) were diagnosed with CKD, 1 patient with hepatorenal syndrome type 2, and 3 patients (0.5%) with AKI on CKD. CONCLUSIONS: Both AKI and CKD are common among hospitalized cirrhotic patients, and often occur simultaneously (16.8%). The most common type of renal dysfunction was AKI (12.9%). Diagnosis of type 2 hepatorenal syndrome remains difficult. A prospective cohort study is warranted to evaluate the clinical course in cirrhotic patients with renal dysfunction.
Acute Kidney Injury/*epidemiology/etiology/mortality ; Adult ; Aged ; Cohort Studies ; Female ; Hospital Mortality ; Humans ; Kidney Failure, Chronic/*epidemiology/etiology/mortality ; Liver Cirrhosis/complications/*diagnosis ; Male ; Middle Aged ; Prevalence ; Prospective Studies ; Severity of Illness Index ; Survival Rate