OBJECTIVE: To determine whether a routine ultrasonography (US) is necessary for diagnosis of developmental dysplasia of hip (DDH), presenting with congenital muscular torticollis (CMT). METHODS: Cases of 133 patients (81 males, 52 females) diagnosed as CMT were reviewed, retrospectively. We reviewed the medical charts and diagnostic examination. We also assessed the coincidence of CMT and DDH, and investigated the clinical features of CMT related to DDH. RESULTS: Twenty (15.0%) patients out of 133 CMT patients were diagnosed as having DDH by US. Of whom, 8 patients were radiographically positive and 4 patients were both clinically and radiographically positive. Nine patients were treated with a harness and 1 of them needed closed reduction and casting. Out of 9 patients treated with a harness, only 4 were clinically positive. The difference and ratio of the sternocleidomastoid (SCM) muscle thickness between the normal and abnormal side was significantly greater in DDH patients (p=0.014). Further, receiver operating characteristic analysis showed when the SCM ratio is greater than 2.08 and the SCM difference is greater than 6.1 mm, the efficiency of US for the diagnosis of the DDH was found to be the best (p<0.05). CONCLUSION: To evaluate DDH, physical examination showed low sensitivity and radiologic study has limitation for the child before 4 to 6 months of age. Therefore, we recommend that hip is screened by US for the diagnosis of DDH associated with CMT when physical examination is positive or CMT patients with large SCM difference and high SCM ratio.
Child ; Hip ; Hip Joint ; Humans ; Male ; Muscles ; Physical Examination ; Retrospective Studies ; ROC Curve ; Torticollis

BACKGROUND: Vascular endothelial growth factor (VEGF) plays an important role in angiogenesis, including stimulating the proliferation and migration of vascular smooth muscle cells (VSMCs). It has been known that diabetes is associated with accelerated cellular proliferation via VEGF, as compared to that under a normal glucose concentration. We investigated the effects of selective blockade of a VEGF receptor by using anti-Flt-1 peptide on the formation and hyperplasia of the neointima in balloon injured-carotid arteries of OLETF rats and also on the in vitro VSMCs' migration under high glucose conditions. MATERIAL AND METHOD: The balloon-injury method was employed to induce neointima formation by VEGF. For 14 days beginning 2 days before the ballon injury, placebo or vascular endothelial growth factor receptor-1 (VEGFR-1) specific peptide (anti-Flt-1 peptide), was injected at a dose of 0.5 mg/kg daily into the OLETF rats. At 14 days after balloon injury, the neointimal proliferation and vascular luminal stenosis were measured, and cellular proliferation was assessed by counting the proliferative cell nuclear antigen (PCNA) stained cells. To analyze the effect of VEGF and anti-Flt-1 peptide on the migration of VSMCs under a high glucose condition, transwell assay with a matrigel filter was performed. And finally, to determine the underlying mechanism of the effect of anti-Flt-1 peptide on the VEGF-induced VSMC migration in vitro, the expression of matrix metalloproteinase (MMP) was observed by performing reverse transcription-polymerase chain reaction (RT-PCR). RESULT: Both the neointimal area and luminal stenosis associated with neointimal proliferation were significantly decreased in the anti-Flt-1 peptide injected rats, (0.15+/-0.04 mm2 and 36.03+/-3.78% compared to 0.24+/-0.03 mm2 and 61.85+/-5.11%, respectively, in the placebo-injected rats (p<0.01, respectively). The ratio of PCNA(+) cells to the entire neointimal cells was also significantly decreased from 52.82+/-4.20% to 38.11+/-6.89% by the injected anti-Flt-1 peptide (p<0.05). On the VSMC migration assay, anti-Flt-1 peptide significantly reduced the VEGF-induced VMSC migration by about 40% (p<0.01). Consistent with the effect of anti-Flt-1 peptide on VSMC migration, it also obviously attenuated the induction of the MMP-3 and MMP-9 mRNA expressions via VEGF in the VSMCs. CONCLUSION: Anti-Flt-1 peptide inhibits the formation and hyperplasia of the neointima in a balloon-injured carotid artery model of OLETF rats. Anti-Flt-1 peptide also inhibits the VSMCs' migration and the expressions of MMP-3 and MMP-9 mRNA induced by VEGF under a high glucose condition.
Animals ; Arteries ; Carotid Arteries ; Cell Proliferation ; Constriction, Pathologic ; Endothelial Growth Factors* ; Glucose ; Hyperplasia ; Muscle, Smooth, Vascular* ; Neointima* ; Phenobarbital ; Rats* ; Rats, Inbred OLETF ; Receptors, Vascular Endothelial Growth Factor ; RNA, Messenger ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factor Receptor-1

Rapid crestal bone resorption following maxillary tooth loss is further accentuated in the posterior regions because of pneumatization and enlargement of the maxillary sinuses. A treatment rationale that allows preservation and augmentation of vertical available bone at the time of posterior maxillary tooth extraction may offer numerous therapeutic benefits which are more short courses of therapy and no needs of additional surgical augmentation. The present study comprised 3 patients who had 4 posterior maxillary teeth with no evident bone between the tooth apex and sinus floor, as estimated through preoperative radiographic analysis. Sinus floor augmentation at the time of tooth extraction was chosen for the ltreatment of these patients. After the tooth was carefully extracted, the empty alveolus was thoroughly debrided and a trephine approach was performed. Particulated autogenous bone was gently pushed beyond the empty alveolus to elevate the sinus membrane using an osteotome. The distance between bone crest and sinus floor was radiographically estimated 4 months after the first procedure. Another procedure was then carried out to place the implants of 11 mm length without another augmentation procedure. All implant were clinically stable, with no sign of infection. The presented surgical procedure performed at the time of extraction of posterior maxillary teeth in close proximity to the sinus floor allowed placement of implants of proper length.
Bone Resorption ; Humans ; Maxillary Sinus ; Membranes ; Sinus Floor Augmentation* ; Tooth Apex ; Tooth Extraction ; Tooth Loss ; Tooth*

Pneumonia is one of important complications after allogeneic bone marrow transplantation (BMT). It is essential to disclose the cause of pneumonia because the treatment depends on the cause. The cause of pneumonia which BMT recipients develop can be infectious as well as noninfectious in origin. Acute eosinophilic pneumonia is a very rare cause of noninfectious pneumonia after BMT. We here report a 42-year-old woman with acute myelogenous leukemia (AML, M4) who developed acute eosinophilic pneumonia on 160 days after unrelated BMT. She was diagnosed by bronchoalveolar lavage and was dramatically improved after steroid treatment.
Adult ; Bone Marrow Transplantation* ; Bone Marrow* ; Bronchoalveolar Lavage ; Eosinophils* ; Female ; Humans ; Leukemia, Myeloid, Acute ; Pneumonia ; Pulmonary Eosinophilia*

OBJECTIVE: The vulvar cancer is an uncommon disease among female population. Because of its rare incidence, sufficient clinical studies have not been accomplished. However, the prevelance of vulvar cancer will continue to increase because of rapid growth of senile population. The goal of this study is to review the clinical outcome and prognosis of patients with vulvar cancer through the analysis of their clinical data. METHODS: We have performed a retrospective clinical study on 23 patients diagnosed with primary invasive vulvar cancer at Asan medical center from May, 1989 to December, 2003. We reviewed demographic data, pathologic findings, treatments, stages, complications, prognosis and survival time. RESULTS: The mean age was 58.9 years. The most common symptoms were palpable mass (69.5%) and itching sense (21.7%). Among the 23 patients, 21 patients have underwent operation, and two patients who refused to receive operation underwent radiotherapy only. 3 of 21 patients who were surgically treated underwent neoadjuvant chemotherapy, and 5 patients, adjuvant radiotherapy. Histopathologically, squamous cell carcinoma (69.5%) was dominant, and 15 patients turned out to have stage II disease or greater (60.8%). Among the 21 patients who have underwent operation, postoperative complications occurred in 8 patients (38.0%) and 4 of them had underwent radical vulvectomy and bilateral groin lymph node dissection. The most common postoperative complication was wound breakdown (23.8%). CONCLUSION: Although surgery is the principal treatment in vulvar cancer, radical vulvectomy and bilateral groin lymph node dissection more often result in complications than other operations such as wide local excision and hemivulvectomy. Considering the mortality and morbidity, the prognosis of vulvar cancer is poor, but early diagnosis and adequate treatment according to each individual will improve the outcome and prognosis of vulvar cancer.
Carcinoma, Squamous Cell ; Chungcheongnam-do ; Drug Therapy ; Early Diagnosis ; Female ; Groin ; Humans ; Incidence ; Lymph Node Excision ; Mortality ; Postoperative Complications ; Prognosis ; Pruritus ; Radiotherapy ; Radiotherapy, Adjuvant ; Retrospective Studies* ; Vulva ; Vulvar Neoplasms* ; Wounds and Injuries

Gemella morbillorum, an anaerobic-to-aerotolerant Gram-positive coccus, is a normal flora of the oral cavity, respiratory tract, urogenital organ and gastrointestinal tract, and infections caused by this organism are unusual. It has been associated mainly with endocarditis and bacteremia, and rarely with arthritis, spondylodiscitis, meningitis, brain abscess and septic shock. Liver abscess caused by G. morbillorum is very rare, and only a few cases were reported. We experienced a case of liver abscess by G. morbillorum in a 56-year-old woman presented with fever. We report this case with a review of literatures.
Female ; Gram-Positive Bacterial Infections/*diagnosis ; Humans ; Liver Abscess/diagnosis/*microbiology ; Middle Aged ; *Staphylococcaceae ; Tomography, X-Ray Computed

Canine atopic skin disease is seasonal or sometimes non-seasonal immune-mediated skin disease which occurs commonly in Korea. The definite clinical sign is systemic pruritus, especially on periocular parts, external ear, interdigit spaces and lateral flank. For diagnosis of this dermatitis, complete history taking followed by intradermal skin test and serum in vitro IgE test needs to be performed. Allergen selection for the diagnosis and treatment of atopic dermatitis should be varied geographically. In this study, with intradermal skin test(IDST) the prevalence of atopic disease and what allergens are involved in are researched. Allergens used for IDST included 26 allergen extracts from six allergen groups: grasses, trees, weeds, molds, epidermal allergens and environmental allergens. The number of allergens was 42 in which the positive and negative controls are included. The most common positive allergen reaction was the house dust mites on IDST(22/35, 63%). The other positive allergen reactions were to flea(3/35, 9%), molds(1/35, 3%), house dusts(2/35, 6%), feathers (1/35, 3%), cedar/juniper(1/35, 3%), timothy grass(1/35, 3%) and dandelion(1/35, 3%). In this study, the most prevalent allergen causing atopic dermatitis in dogs in Korea was the house dust mites followed by the flea.
Allergens/*immunology ; Animals ; Dermatitis, Atopic/immunology/*veterinary ; Dog Diseases/*immunology ; Dogs ; Female ; Male ; Skin Tests/veterinary

OBJECTIVES: Our purpose was to evaluate the efficacy of pelviscopic classic intrafascial supracervical hysterectomy (CISH) & compare it with total abdominal hysterectomy (TAH). METHODS: We analyzed retrospectively, the clinical data of 1126 patients admitted from January 1993 to December 1998, at 11 university or general hospitals in Korea, for CISH group and 363 patients admitted from January 1993 to December 1998, at Chung-Ang university hospitals, Seoul, Korea, for TAH group. These patients were operated on with the indication of benign uterine disease without cervical malignant lesion. The patients with malignant cervical lesion were excluded in this study. RESULTS: (1) The average age of CISH group was 42.2 (range 24-63) years old and TAH group was 46 (range 31-54) years old. (2) The mean operative time was 150.7+/-49.9 (mean+/-SD, range 55-395) minutes in CISH group and 133.8+/-35 (mean+/-SD, range 65-350) minutes in TAH group. The mean estimated blood loss was 206+/-183.6 (mean+/-SD, range 20-2000) ml in CISH group and 596+/-452.3 (mean+/-SD, range 100-6500) ml in TAH group. The mean hemoglobin change was 1.52+/-0.98 (mean+/-SD, range 0-7) g/dL in CISH group and 3.03+/-1.47 (mean+/-SD, range 0.2-8.4) g/dL in TAH group. The mean time in hospital was 6.3+/-1.43 (mean+/-SD, range 3-18) days in CISH group and 11.0+/-4.08 (mean+/-SD, range 7-37) days in TAH group. (3) Overall complications occured at 5.3% in CISH group and 9.1% in TAH group. (4) Pathologic findings of cervix were benign in 1121 patients (99.6%) and severe dysplasia or carcinoma in situ in 5 patients (0.4%) among CISH groups. In TAH groups, 351 patients (96.7%) had benign cervical lesion and 12 patients (3.3%) had more than oderate dysplasia or carcinoma in situ. In both groups, no invasive cervical cancer was found and the transformation zone of the cervix was included within the resection margin of the cervix in all cases. CONCLUSION: The pelviscopic CISH group has less operative blood loss, less postoperative hemoglobin change, shorter hospital stay and less operative complication than TAH group. Pelviscopic CISH is truly a minimally invasive and organ-preserving surgery and coring out the cervix with the calibrated uterine resection tool may prevent the development of cervical cancer. Therefore, we believe that pelviscopic CISH is preferred in cases of benign uterine diseases, because it lowers operative complications and it may have several benefits compared with total hysterectomy, especially, in women with no pathologic lesion of the cervix.
Carcinoma in Situ ; Cervix Uteri ; Female ; Hospitals, General ; Hospitals, University ; Humans ; Hysterectomy* ; Korea ; Length of Stay ; Operative Time ; Retrospective Studies ; Seoul ; Uterine Cervical Neoplasms ; Uterine Diseases

OBJECTIVE: To estimate the long-term skeletal responses to hormone replacement therapy(HRT) with or without active vitamin D(VD) by using short-term changes of bone markers in postmenopausal women (PMW). METHODS: Biochemical markers of bone formation(osteocalcin,OC) and (&) resorption(deoxypyridinoline, Dpd ) at 3 months & lumbar bone mineral density(BMD) at 1 year were measured in 64 natural PMW taking HRT(n=41) & HRT with calcitriol 0.25 microgram/day(n=23). The correlation of percent changes of bone markers after 3 months of Tx with those in lumbar BMD after 1 year was evaluated. RESULTS: 1. serum-OC & urine-Dpd showed decrease of 20.9% & 30.1% at 3months respectively & BMD increase of 3.8% after 1 year of Tx. 2. Among 58 PMW with decreased u-Dpd change, 49 (84.5%) revealed increase in BMD, while 40 (81.6%) among 49 PMW with decreased serum-OC change showed increased BMD. 3. Bone gainers showed significant decrease in changes of serum-OC(18.1% vs 9.2% p<0.05) & urine-Dpd(32.6% vs 20.4%, p<0.05) compared with those of bone losers. 4. No correlations of change of serum-OC (r=-0.174 p>0.05) & urine-Dpd (r=-0.091 p>0.05) at 3month with BMD changes at 1year were seen in total PMW, but urine-Dpd changes in HRT without active VD group revealed significantly inverse correlation(r=-0.376 p<0.05). CONCLUSION: Short-term changes of bone markers did not precisely predict the long-term changes of BMD in total PMW except urine- Dpd in HRT without active VD.
Biomarkers ; Bone Density* ; Calcitriol ; Estrogen Replacement Therapy* ; Female ; Humans ; Osteocalcin ; Vitamin D* ; Vitamins*

No abstract available.
Joints*