Purpose: Commonly used surgical approaches for internal plate fixation of transcondylar distal humeral fractures may require ulnar nerve release or anterior transposition, and extensive surgical dissection can cause triceps weakness. This study reports the surgical technique and clinical outcomes of a medial and lateral approach for dual-plate fixation of transcondylar distal humeral fractures without ulnar nerve release or extensive surgical dissection. Methods: Sixteen patients (mean age, 81.25 years; range, 70–95 years) who underwent plate fixation using a medial and lateral approach for distal humeral transcondylar fractures were retrospectively reviewed. An anatomical distal humerus parallel or orthogonal locking plate was used for internal fixation. Ulnar nerve release was not performed in any patients. Surgical outcomes were evaluated 1 year postoperatively based on the level of pain, elbow range of motion, the Mayo elbow performance score, and postoperative complications. Results: The mean visual analog scale score was 0.47. The mean range of motion of the elbow joint was 13.8° for extension and 131.8° for flexion. The Mayo Elbow Performance Score was excellent in nine patients and good in seven. Bone union was achieved in all patients. There were no complications such as ulnar neuropathy, heterotopic ossification, or infection. Conclusion In transcondylar distal humeral fracture in older adults, a medial and lateral approach with dual anatomical locking plate fixation is recommended as a surgical technique that has the advantage of enabling rigid fixation without necessitating ulnar nerve release and extensive surgical dissection. Nonetheless, further research should be conducted.

Purpose: Commonly used surgical approaches for internal plate fixation of transcondylar distal humeral fractures may require ulnar nerve release or anterior transposition, and extensive surgical dissection can cause triceps weakness. This study reports the surgical technique and clinical outcomes of a medial and lateral approach for dual-plate fixation of transcondylar distal humeral fractures without ulnar nerve release or extensive surgical dissection. Methods: Sixteen patients (mean age, 81.25 years; range, 70–95 years) who underwent plate fixation using a medial and lateral approach for distal humeral transcondylar fractures were retrospectively reviewed. An anatomical distal humerus parallel or orthogonal locking plate was used for internal fixation. Ulnar nerve release was not performed in any patients. Surgical outcomes were evaluated 1 year postoperatively based on the level of pain, elbow range of motion, the Mayo elbow performance score, and postoperative complications. Results: The mean visual analog scale score was 0.47. The mean range of motion of the elbow joint was 13.8° for extension and 131.8° for flexion. The Mayo Elbow Performance Score was excellent in nine patients and good in seven. Bone union was achieved in all patients. There were no complications such as ulnar neuropathy, heterotopic ossification, or infection. Conclusion In transcondylar distal humeral fracture in older adults, a medial and lateral approach with dual anatomical locking plate fixation is recommended as a surgical technique that has the advantage of enabling rigid fixation without necessitating ulnar nerve release and extensive surgical dissection. Nonetheless, further research should be conducted.

Purpose: Commonly used surgical approaches for internal plate fixation of transcondylar distal humeral fractures may require ulnar nerve release or anterior transposition, and extensive surgical dissection can cause triceps weakness. This study reports the surgical technique and clinical outcomes of a medial and lateral approach for dual-plate fixation of transcondylar distal humeral fractures without ulnar nerve release or extensive surgical dissection. Methods: Sixteen patients (mean age, 81.25 years; range, 70–95 years) who underwent plate fixation using a medial and lateral approach for distal humeral transcondylar fractures were retrospectively reviewed. An anatomical distal humerus parallel or orthogonal locking plate was used for internal fixation. Ulnar nerve release was not performed in any patients. Surgical outcomes were evaluated 1 year postoperatively based on the level of pain, elbow range of motion, the Mayo elbow performance score, and postoperative complications. Results: The mean visual analog scale score was 0.47. The mean range of motion of the elbow joint was 13.8° for extension and 131.8° for flexion. The Mayo Elbow Performance Score was excellent in nine patients and good in seven. Bone union was achieved in all patients. There were no complications such as ulnar neuropathy, heterotopic ossification, or infection. Conclusion In transcondylar distal humeral fracture in older adults, a medial and lateral approach with dual anatomical locking plate fixation is recommended as a surgical technique that has the advantage of enabling rigid fixation without necessitating ulnar nerve release and extensive surgical dissection. Nonetheless, further research should be conducted.

No abstract available.
Glycopeptides*

BACKGROUND: Myxoma makes up close to 50% of adult primary cardiac tumors, and this mainly occurs in the left atrium, and rarely in the right atrium or ventricle. The patients clinically present with symptoms of hemodynamic obstruction, embolization or constitutional changes. Diagnosis is currently established most appropriately with 2-D echocardiography. Surgical resection of myxoma is a safe and effective treatment. MATERIAL AND METHOD: We reviewed our clinical experience in the diagnosis and management of 57 cases of cardiac myxoma that were seen over a 20-year period from July 1984 to July 2004. RESULT: The mean age of the patients was 53.5+/-14.0 years (range: 12 to 76 years). There were 38 (67%) females and 19 (33%) males. The preoperative symptoms included dyspnea on exertion in 27 patients, palpitation in 4, chest pain in 9 and syncopal episode in 4. The diagnosis was made by echocardiography alone in 51, and by combination of echocardiography, CT and angiography in 6. The tumor attachment sites were the interatrial septum in 50, the mital valve annulus in 3 and the left atrial wall in cases. The tumor was excised successfully via biatriotomy in 33 (58%), left atriotomy in 15 (26%), the septal approach via right atriotomy in 3, Inverted T incision in 3 and the extended septal approach in 3. The follow-up time ranged from 1 to 229 months (mean follow-up: 84.0+/-71.3 months). There were no early and late deaths and no recurrence during the follow-up period except for follow-up loss in 5 patients. CONCLUSION: It's concluded that excision of cardiac myxoma is curative and the long-term survival is excellent. Immediate surgical treatment was indicated because of the high risk of embolization or of sudden cardiac death. Radical tumor excision may prevent recurrences.
Adult ; Angiography ; Chest Pain ; Death, Sudden, Cardiac ; Diagnosis ; Dyspnea ; Echocardiography ; Female ; Follow-Up Studies ; Heart Atria ; Heart Neoplasms ; Hemodynamics ; Humans ; Male ; Myxoma* ; Recurrence ; Syncope

OBJECTIVE: Etoposide is a potent and widely used antineoplastic agent. It is able to induce apoptosis in most cell types. However, very little is known about its mechanism of action. In this study, we demonstrate the cytotoxic signal that induced by etoposide and investigate how etoposide exerts antitumor activity in HPV-16 (+) CaSki cervical carcinoma cells. METHODS: Antiproliferation activity was measured in CaSki cell lines by using MTT assays, DNA fragmentation assay. Cell cycle distribution was analyzed using flow cytometry. Expression of proteins involved in the apoptotic pathway was analyzed by Western blotting (WB). Electron microscopic (EM) and biochemical studies (Western blotting, RT-PCR) revealed that non-apoptotic death was associated with autophagosomes/-autolysosomes. These parameters have also been measured in cells treated with 3-methyladenine (an autophagy inhibitor), zVAD-fmk (a pan-caspase inhibitor) and both. RESULTS: The etoposide induced apoptosis. In cell cycle analysis, etoposide-treated CaSki cells were few induced hypodiploid DNA content, suggesting that apoptotic cell death. EM study revealed that autophagic appearance in the presence of etoposide exhibited by autophagosomes/autolysosomes. It was confirmed by LysoTracker probe and WB against Beclin 1, APG 5, APG 12 and p53. When autophagy was blocked by 3-MA, not only the protein expression of Beclin 1, but also the antitumor effect of etoposide was suppressed. On the other hand, the addition of zVAD-fmk could induce a few etoposide-induced autophagy. And etoposide-treated CaSki cells were rescued by combination of 3-MA and zVAD-fmk. CONCLUSION: Our results suggest that etoposide not only initiated apoptosis but ultimately caused cell death through autophagy. In this study, we demonstrate novel features for the action of etoposide in HPV-16 (+) CaSki cervical carcinoma cells. Autophagic cell death induction by some anticancer agents underlines the potential utility of its induction as a new cancer treatment modality.
Antineoplastic Agents ; Apoptosis ; Autophagy ; Blotting, Western ; Cell Cycle ; Cell Death* ; Cell Line ; DNA ; DNA Fragmentation ; Etoposide* ; Flow Cytometry ; Hand ; Human papillomavirus 16 ; Uterine Cervical Neoplasms*

Addisons disease is relatively rare than secondary adrenal insufficiency and result from progressive adrenocortical destruction. The common causes are idiopathic autoimmune atrophy and tuberculosis of adrenal glands. It is generally regarded as incurable in the sense that substitution therapy is required for the rest of the patients life. We report a case of tuberculous primary adrenal insufficiency which was confirmed by biopsy. This case was treated with antituberculous medication and showen to have improved adrenocortical function after six months.
Addison Disease* ; Adrenal Glands ; Adrenal Insufficiency ; Atrophy ; Biopsy ; Humans ; Tuberculosis

PURPOSE: To analyze the causes of fixation failure of compression hip screw and evaluate outcomes of hip arthroplasty for reconstruction. MATERIALS AND METHODS: We reviewed 108 femoral intertrochanteric fractures that underwent compression hip screw between January 1997 and December 2007. Failure group (group I) contained 28 cases who had hip arthroplasty for failed compression hip screw and the control group (group II) contained 80 cases who had successive compression hip screw. We analyzed the causes of failure of compression hip screw and evaluated the results of hip arthroplasty for reconstruction. RESULTS: In group I, 21 cases (75%) were unstable fractures. Group II, 14 cases (17%) were unstable fractures. Tip-apex distance was 26.5 (18~35) mm in group I and 18.6 (8~22) mm in group II. Lateral wall fracture of greater trochanteric area was combined in 24 cases (85.7%) in group I and 9 cases (11.3%) in group II. Harris Hip Score improved from 33.5 (22~43) points to 84.2 (75~93) points after salvage hip arthroplasty. CONCLUSION: We considered the causes of failed compression hip screw to be fracture instability, increased tip-apex distance and presence of lateral wall fracture of greater trochanter. Hip arthroplasty was found to be a useful method for failed compression hip screw.
Arthroplasty ; Femur ; Hip ; Hip Fractures

Mucormycosis is a rare, fulminating, opportunistic fungal infection that occurs almost exclusively in immunocompromised hosts such as patients with diabetes, leukemia, lymphoma. These fungi are ubiquitous in nature, and can be found on decaying vegetation and in the soil. So they are relatively frequent contaminants in the clinical microbiology laboratory. Recently the incidence of mucormycosis is rising associated with the increasing use of immunosuppressive agents, antibiotics. Though mucormycosis is frequently fatal, there has been a significant improvement in the outcome by early diagnosis and aggressive treatment. Mucormycosis can be categorized as rhinocerebral, pulmonary, gastrointestinal, cutaneous, widely disseminated and miscellaneous; gastro-intestinal involvement is extremely rare. We report a patient with gastric mucormycosis who had diabetes mellitus and alcoholic hepatitis. His chief complaint was an epigastric pain, and the gastroscopy showed huge multiple ulcers, coated with exudates. The histologic examination revealed multiple broad, nonseptate hyphae with right angle branchings, diagnosed as mucormycosis.
Alcoholics* ; Anti-Bacterial Agents ; Diabetes Mellitus* ; Early Diagnosis ; Exudates and Transudates ; Fungi ; Gastroscopy ; Hepatitis, Alcoholic* ; Humans ; Hyphae ; Immunocompromised Host ; Immunosuppressive Agents ; Incidence ; Leukemia ; Lymphoma ; Mucormycosis* ; Soil ; Ulcer

No abstract available.
Asphyxia* ; Erythrocyte Count* ; Erythrocytes* ; Humans ; Hyaline Membrane Disease ; Infant, Newborn