Hepatic hemangioma: proportion and predictor of surgical treatment with emphasis on its growth rate

Background/Aims@#There are limited studies on the management of hepatic hemangiomas (HHs). We investigated the proportion and predictors of surgical resection and analyzed HH growth rates in addition to associated factors. @*Methods@#A retrospective case-control study of patients treated in 2 centers was conducted. Thirty-six patients who underwent surgical resection were assigned to the case group. Patients who did not undergo surgical treatment were randomly sigselected at a 1:10 ratio and assigned to the control group (n = 360). Baseline characteristics, clinical course and surgical outcomes were analyzed. @*Results@#The proportion of surgically treated HH patients was 0.3% (36 per 11,049). The longest diameter at diagnosis (mean ± standard deviation) was 7.7 ± 5.2 cm in the case group and 2.4 ± 1.8 cm in the control group (p 10 cm (OR 10.50, 95% CI 1.06–103.77, p = 0.04). The subgroup analysis showed substantial growth in 41.3% with an overall mean annual growth rate of 0.14 cm. @*Conclusions@#Approximately one in 300 patients with an HH underwent surgical treatment. Multiple HHs and a growth rate of more than 4.8%/year were indications for surgical treatment. Nearly half of the HHs showed growing pattern in our study.

Unusual reaction to Hymenoptera stings

Reactions to Hymenoptera stings are classified into local reactions, large local reactions, systemic anaphylactic reactions, systemic toxic reactions, and unusual reactions. They are also classified into immediate and delayed reactions. The most frequent clinical patterns are large local and systemic anaphylactic reactions. The skin, and the gastrointestinal, respiratory, and cardiovascular systems can be involved. A variety of unusual or unexpected reactions, such as acute encephalopathy, acute renal failure, nephrotic syndrome, silent myocardial infarction, diffuse alveolar hemorrhage, rhabdomyolysis, and cataracts, occur in a temporal relationship to insect stings. Here, we report a 31-year-old woman with delayed generalized edema, weight gain, and unusual reactions 24 hours after bee sting.

Signal Transduction Factors on the Modulation of Radiosusceptibility in K562 Cells / 대한방사선종양학회지

PURPOSE: The human chronic myelogenous leukemia cell line, K562, expresses the chimeric bcr-abl oncoprotein, whose deregulated protein tyrosine kinase activity antagonizes the induction of apoptosis via DNA damaging agents. Previous experiments have shown that nanomolar concentrations of herbimycin A (HMA) coupled with X-irradiation have a synergistic effect in inducing apoptosis in the Ph-positive K562 leukemia cell line, but genistein, a PTK inhibitor, is non selective for the radiation-induced apoptosis of p210bcr/abl protected K562 cells. In these experiments, the cytoplasmic signal transduction pathways, the induction of a number of transcription factors and the differential gene expression in this model were investigated. MATERIALS AND METHODS: K562 cells in the exponential growth phase were used in this study. The cells were irradiated with 0.5-12 Gy, using a 6 MeV Linac (Clinac 1800, Varian, USA). Immediately after irradiation, the cells were treated with 0.25 microM of HMA and 25 microM of genistein, and the expressions and the activities of abl kinase, MAPK family, NF-kB, c-fos, c-myc, and thymidine kinase1 (TK1) were examined. The differential gene expressions induced by PTK inhibitors were also investigated. RESULTS: The modulating effects of herbimycin A and genistein on the radiosensitivity of K562 cells were not related to the bcr-abl kinase activity. The signaling responses through the MAPK family of proteins, were not involved either. In association with the radiation-induced apoptosis, which is accelerated by HMA, the expression of c-myc was increased. The combined treatment of genistein, with irradiation, enhanced NF-kB activity and the TK1 expression and activity. CONCLUSION: The effects of HMA and genistein on the radiosensitivity of the K562 cells were not related to the bcr-abl kinase activity. In this study, another signaling pathway, besides the MAPK family responses to radiation to K562 cells, was found. Further evaluation using this model will provide valuable information for the optional radiosensitization or radioprotection.

Bipolar Endoprosthesis between Femoral Neck Fracture and Avascular Necrosis of Femoral Head: Comparison of the Acetabular Migration and Function / 대한정형외과학회잡지

In 1974, bipolar hip prosthesis was developed by Giliberty and Bateman to reduce the problems of unipolar prosthesis, including acetabular wear and acetabular protrusion, but the indications for it are still controversial. From July, 1988, to February, 1991, at Pusan maryknoll hospital, 37 hips in 33 patients of femoral neck fracture (25 hips) and avascular necrosis (12 hips) with relatively normal acetabular articular cartilage were treated with bipolar hip prosthetic replacement. The thirty-seven cases were reviewed for more than 3 years(range, 3 years to 4 years 8 months: average, 3 years 10 months), and assessed in terms of acetabular migration and function. The authors compared the datas of the femoral neck fracture with those of the avascular necrosis of femoral head. There was no statistical difference between two groups in function. But the acetabular migration of bipolar hip prosthesis used in femoral neck fracture was lesser than that of avascular necrosis of femoral head, and the serial acetabular migration disclosed gradual decrease. The authors concluded that the results of bipolar endoprosthesis used in femoral neck fracture was superior than those of avascular necrosis of femoral head with relatively normal acetabular articular cartilage.

The Use of Ender nails in Distal One-Third Fractures of Tibia / 대한정형외과학회잡지

The distal one-third fractures of tibia have much difficulty in treatment due to enumerous complications such as skin necrosis, angular deformity and delayed union. As for using Ender nails in distal tibial fractures, the stability of fixation can be strengthened with fanning of the nails in distal fragments and using more than 3 nails and 1cm longer nail. Twenty-two patients having distal tibial fractures, were carried out Ender nailing at Department of Orthopaedic Surgery, Maryknoll Hospital from May 1989 to September 1992. The results were as follows; 1. The distal end of fracture line was situated from 3cm to 9cm above plafond, and the mean duration of radiological bony union was 14.9 weeks except one case of nonunion. 2. Mild angulation developed in two cases and complications such as nonunion, superficial infection and backing out of nail were noted, but it did not affect the results.

Treatment of the tibial shaft fractures with ender nails / 대한정형외과학회잡지

No abstract available.

A clinical study of fracture of the neck of the talus / 대한정형외과학회잡지

No abstract available.

The treatment of the lateral malleolar fracture of the ankle with a gripper plate / 대한정형외과학회잡지

No abstract available.

The Fractured Carpal Scaphoid / 대한정형외과학회잡지

The carpal scaphoid is the commonest of the carpal bones to be fractured, and this injury is the commonest to befall the wrist of working man. There is still some disaggrement as to the optimum treatment and as to how long immobilization should be maintained. The twenty seven cases of the carpal scaphoid were treated at department of orthopaedic surgery, Maryknoll Hospital. They were analyzed in regared to the clinical and radiological aspects. The results were summarized as follows. l. Of 27 cases 24 cases were in the age group 20 to 39, and all cases were male patients. 2. In 17 cases, the fracture was found in right side. 3. In 19 cases (70.4%), the fracture was found on the middle 1/3 of the carpal scaphoid and in 18 cases(66.8%), the fracture line was transverse. 4. The union rate of fracture was 100% in the distal 1/3 fracture, 89.5% in the middle 1/3 fracture and 66.3% in the proximal fracture. The average period of immobilization were 10.3, 14.9 and 15.3 weeks respectively. 5. By Maudsley's assessment, the end result was good in all cases of the distal 1/3 fracture, 84.2% in the middle 1/3 fracture and 66.7% in the proximal 1/3 fracture. 6. Traumatic arthritis developed in 3 cases, avascular ncerosis in 7 cases, nonunion in 4 cases.