In this study, the trypsin gene (bgtryp-1) from the German cockroach, Blattella germanica, was cloned via the immunoscreening of patients with allergies to cockroaches. Nucleotide sequence analysis predicted an 863 bp open reading frame which encodes for 257 amino acids. The deduced amino acid sequence exhibited 42-57% homology with the serine protease from dust mites, and consisted of a conserved catalytic domain (GDSGGPLV). bgtryp-1 was determined by both Northern and Southern analysis to be a 0.9 kb, single-copy gene. SDS-PAGE and Western blotting analyses of the recombinant protein (Bgtryp-1) over-expressed in Escherichia coli revealed that the molecular mass of the expressed protein was 35 kDa, and the expressed protein was capable of reacting with the sera of cockroach allergy patients. We also discussed the possibility that trypsin excreted by the digestive system of the German cockroach not only functions as an allergen, but also may perform a vital role in the activation of PAR-2.
Allergens/analysis/chemistry/*genetics ; Amino Acid Sequence ; Base Sequence ; Blattellidae/*genetics ; Blotting, Western ; Catalytic Domain/genetics ; DNA, Complementary/genetics ; Escherichia coli/metabolism ; Female ; *Genes, Insect ; Humans ; Male ; Molecular Sequence Data ; Molecular Weight ; Receptor, PAR-2/metabolism ; Recombinant Proteins/analysis/biosynthesis/chemistry ; Research Support, Non-U.S. Gov't ; Sequence Alignment ; Sequence Homology, Amino Acid ; Trypsin/analysis/chemistry/*genetics

No abstract available in English.
Arthritis ; Arthritis, Rheumatoid

A retrospective study was undertaken to define the factors that cause the neurogenic symptoms in 18 cases of spondylolytic spondylolisthesis who were operated for leg pain and neurologic deficits of motor functions documented by neurologic examination or electromyographic findings in the Department of Orthopaedic Surgery, Fatima Hospital, Daegu for three years since June, 1986. The cases having other combined pathology to cause neurogenic symptoms were excluded. The causes were predetermined by preoperative x-rays, myelograms, electromyograms, and computerized tomograms and the causes were explored at surgery regarding the preoperative findings. The findings were compared with the avilable findings of 13 cases who were operated for low back pain only without any neurogenic pain in the leg during the same period. The cases were quite older and had narrower disc spaces than the back pain group but there were no significant differences in the degree of slipping and stability of slipped level between the two groups. The foraminal stenosis was found in all of the cases and a central stenosis was combined in a case. The intervertebral foramens were narrowed up-down in most of the cases between the bony prominence of proximal pars interarticularis above and the disc and vertebral body below but three cases had soft tissue mass only at the isthmic defect encroaching the foramen. There were hypertrophy of bone and/or soft tissue at the pars interarticularis in all cases. The nerve roots were mainly compressed up-down below pars interarticularis in the foramen in 8 cases and impinged at the anterior foramen in front of the pars interarticularis in 10 cases. The central stenosis was due to marked bony hypertrophy of pars interarticularis and osteophyte of vertebral body. The causes of neurogenic symptoms in spondylolytic spondylolisthesis were foraminal stenosis due to hypertrophy of bone and/or soft tissue at the pars interarticularis combined with narrowing of disc and seemed to be a process of degenerative changes occurring at the motion segment of slipped level.
Back Pain ; Constriction, Pathologic ; Daegu ; Hypertrophy ; Leg ; Low Back Pain ; Neurologic Examination ; Neurologic Manifestations ; Osteophyte ; Pathology ; Pheniramine ; Retrospective Studies ; Spondylolisthesis

No abstract available.
Dinoprost* ; Flurbiprofen* ; Gabexate* ; Prednisolone* ; Thromboxane B2*

Visual loss and field defects commonly occur after acute blood loss. We present a case of bilateral permanent visual field defect in a 30-year-old man after a massive hemorrhage caused by large vessel injury during a right nephrectomy. His postoperative visual acuity decreased significantly, and his visual field showed peripheral constriction and inferior altitudinal field defect in both eyes. A year and a half after the operation, visual acuity recovered to the preoperative level, but the field did not show improvement. We advance that this is a possible result of extensive injury to the occipital area, excluding the corresponding area of the macula.
Acute Disease ; Adult ; Blindness/*etiology ; Blood Loss, Surgical/*physiopathology ; Cerebral Infarction/complications/*etiology ; Humans ; Male ; Nephrectomy ; Occipital Lobe/pathology ; Vena Cava, Inferior/injuries ; Vision Disorders/*etiology ; *Visual Fields

No abstract available.
Forearm*

Low back pain and radiating pain in the leg are the main symptoms of the spondylolisthesis and various surgical treatments are recommended after having enough conservative treatments. The spinal fusion in situ either posterior, posterolateral or anterior route is the usual method for symtomatic spondylolisthesis or to prevent progression of slipping but the neurogenic symptoms in the legs are not well solved, so the decompression procedures are necessary. The authors reviewed 26 cases of isthmic spondylolisthesis having low back pain and sciatica which are operated during the 10 years since 1973 at Fatima Hospital and the followings are obtained. 1. There were 15 males and 11 females with ages from 18 years to 63 years having average 40.1 years. 2. The displaced vertebrae were 5th lumbar in 18 and 4th lumbar in 8 cases and the degree of displacement was Grade I in 14, Grade II in 10, Grade III in 1 and no slipping in 1 case. 3. The types of surgery were decompression and H-graft in 22, simple posterior fusion in 3 and Gll's procedure in 1 case. 4. The laminas were considerably loose in all cases and there were small fibrous mass at the pars area in half of the cases. .5. The spine became very stable immediately after H-grafting and the intervertebral foramen became widened freeing nerve root. 6. Bony union obtained in 88% and satisfactory result in 85% at the follow-up from 6 months to 7 years and 2 months with average 1 year and 7 months. 7. The decompression is necessary for the radiating pain in the leg and H-grafting is satisfactory and simple procedure after decompression laminectomy.
Decompression ; Female ; Follow-Up Studies ; Humans ; Laminectomy ; Leg ; Low Back Pain ; Male ; Methods ; Sciatica ; Spinal Fusion ; Spine ; Spondylolisthesis

Primary subacute pyogenic osteomyelitis is defined as a bone infection of insidious onset lasting for more than several weeks without any acute systemic toxic reactions and is known to have the problem of diagnosis because there is no inflammatory symptoms or signs and X-ray findings are similar to various bone tumors. Authors reviewed 29 cases of primary subacute pyogenic osteomyelitis of long bones admitted at Fatima hospital during the years between 1976 and 1984. The osteomyelitis of infants and the osteomyelitis modified by antibiotics were excluded. The diagnosis of the cases was confirmed by bacteriological examination and/or tissue examination. The results were as follows. 1. The cases were 18 males and 11 females and 19 adults and 10 children. Male predominence was noted in children. 2. The involved bones were 11 tibias, 10 femurs and all other long bones. The involved sites were 18 metaphysis and 11 shafts. 3. All of the cases has insidious onset of local pain without any acute systemic symptoms and most of the cases has local tenderness but local deep swelling noted in about half of the cases. 4. There were many cases with elevated ESR and a few cases of slight leukocytosis. 5. The confirmed infecting organism was all staphylococcus in 16 cases of the cultures from the 25 lesions. 6. The X-ray findings were Brodies abscess in 10, illdefined cavity in 3, diffuse bones absorption in 5, diaphyseal lesion of adult with localized cortical sclerosis in 5 and with localized medullary abscess in 3 and diaphyseal lesion of children with localized medullary abscess and periosteal reaction in 3 cases. 7. All of the cases cured rapidly with rare recurrence after treatment by simple local excision in 4 and curettage in 22 cases combined with antibiotic therapy and local immobilization.
Abscess ; Absorption ; Adult ; Anti-Bacterial Agents ; Child ; Curettage ; Diagnosis ; Female ; Femur ; Humans ; Immobilization ; Infant ; Leukocytosis ; Male ; Osteomyelitis ; Recurrence ; Sclerosis ; Staphylococcus ; Tibia

The management of the femoral neck fractures remains a major challenge to the orthopaedic surgeons because there are many critical complications such as non-union and avasular necrosis in spite of the advanced technics of treatment. The posterior comminution of this fracture is known to be an important comtributing factor of these complications as the most important cause of the instalility of reduction after internal fixation as well as difficulty of stable reduction, Authors reviewed 61 cases of the femoral neck fractures which were able to identify the presence or absence of posterior comminution on x-ray or operative findings and were managed at Daegu Fatima Hospital during the 10 years from 1975 to 1984 and the following results were obtained. 1. The incidence of posterior comminution in 61 femoral neck fractures was 56% in x-rays of lateral view and operative findings. 2. Open reductions were performed in 31% of 39 cases in which reductions were necessary for internal fixation and 43% of the fractures with posterior comminution were unstable to reduce by closed method while 88% of the fractures without postrior comminution were reduced by closed method. 3. The positions of reductio were in valgus in 46% and anatomic in the rest of cases and valgus reductions were more common in the cases of posterior comminution. 4. Loss of the reduction after internal fixation noted in 48% of the fractures with posterior comminution and 9% without posterior comminution. 5. 77% of the fractures united including 14% of mal-union and the late complication of non-union noted in 14% and avascular necroris in 9% in 35 cases which were followed for over 1 year. 6. The normal unions were more common in the fractures without posterior comminution, the cases of open reduction and the reduction in valgus position. 7. Most of the mal-unions and non-unions noted in the fractures with posterior comminution, the cases of closed reduction and the reduction in anatomic position. 8. These results suggest that the posterior comminution of the femoral neck fracture causes considerable instability and the better results could be expected in the femoral neck fractures with posterior comminution by the reduction in valgus and by the open reduction if necessary.
Clinical Study ; Daegu ; Femoral Neck Fractures ; Femur ; Femur Neck ; Incidence ; Methods ; Necrosis ; Surgeons

The displaced femoral neck fractures remain a major challenge to orthopaedic surgeons as the elderly population is increasing. Successful union by internal fixation after adequate reduction without avascular necrosis is primary goal since the functional results having own femoral head are much superior to those having prosthetic femoral head, but prosthetic replacement is indicated for some patients with fresh fractures who need early ambulation as well as neglected fractures and failed internal fixations. The early result after prosthetic replacement was known to be very satisfactory but the late complications are becomming the major problem. Authors reviewed 21 cases of the prosthetic replacements for the femoral neck fractures which were followed for more than one year and managed at Fatima Hospital during the years between 1975-1984 and the following results were obtained. 1. The cases were 8 males and 13 females having ages from 42 to 87 years with average 69 years old. 2. The cases were 11 elderly fresh fractures, 6 neglected fractures, 2 failed osteosynthesis and 2 others. 3. Moore and Thompson prosthesis were used and 13 of them were fixed with bone cement. 4. The early result evaluated at 3 months after surgery revealed satisfactory in 90% but the final result at average 3 years and 5 months ranging from 1 year to 6 years and 2 months revealed satisfactory results in 58% 5. There was no significant early post-operative complications. 6. The late complications were 8 cases of acetabular erosions and these were combined with stem loosening in 2, subsidence in 2 and deep infection in 1 case. 7. The late complications started to reveal at about 3 years after surgery and occurred in younger and active patient. 8. The prosthetic replacement for femoral neck fracture is recommended for the inactive patient or the patient with expected activity less than 3 years.
Acetabulum ; Aged ; Early Ambulation ; Female ; Femoral Neck Fractures ; Femur Neck ; Head ; Humans ; Male ; Necrosis ; Prostheses and Implants ; Surgeons