Fractures of the upper end of the humerus are common and account for 4% to 5% of all fractures. They occur more frequently in older patients. In older patient the fracture often results from a minor fall and can be extremely disabling and their management often demands experienced surgical skill and judgement. Fortunately, in 80% of upper humeral fractures none of the four major segment is significantly displaced. These lesions are amenable to simple treatment by early function exercises. In 15% to 20% of upper humeral fractures one or more of the major segment is displaced. They are often unstable, may not be reduced by closed method. Many different methods of open reduction and internal fixation has been used and are still employed. These include wire loops, screw, staples, plates, intramedullary nail, but adequate internal fixation was not easily achieved due to the osteoporosis, displacement and shape of fragment. We treated 8 cases of surgical neck fractures by Rush pin and tension band wiring method. We consider this method as effective, simple and rigid fixation technique to attempt early exercise and to restore normal range of motion.
Exercise ; Humans ; Humeral Fractures ; Humerus ; Methods ; Neck ; Osteoporosis ; Reference Values

Rhus has been known to one of the most frequent plants which produce allergic contact dermatitis. Allergenic component of thus is urushiol which is composed of catechols with a 15-carbon-atom side-chain. Systemic administration can produced hematogenous contact dermatitis and also severe systemic reactions such as drowsiness, convulsion, nausea, vomiting, glomerulonephritis and urticaria. We experienced a case of right anterior and posterior watershed cerebral infarction, generalized urticaria and allergic contact dermatitis following ingestion of urushiol.
Catechols ; Cerebral Infarction* ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Eating* ; Glomerulonephritis ; Nausea ; Rhus ; Seizures ; Sleep Stages ; Urticaria ; Vomiting

Hemichorea-hemiballsim has been reported as a rare Implication of nonketotic hyperglycemia. Recently, Some reports revealed that brain magnetic resonance images of nonketotic hyperglycemic patients with hemichorea-hemiballism showed characteristic contralateral striatal signal abnormality, We present six patients with hemichorea-heniiballism. All of them had diabetes mellitus and performed brain MR images. The MR images of them showed high signal intensity on Tl-weighted images and low signal intensity on T2 weighted images in the striatum contralateal to the involuntary movement. In general, the striatal high signal intensity on TI weighted images are presumed to have developed following hemorrhagic transformation, osmotic myelinolysis, or mild ischemia with reversible deposition of calcium or other material occurred in association with nonketotic hyperglycemia. However the precise mechanism of this signal change is not clear yet and needs pathological confirmation.
Brain ; Calcium ; Diabetes Mellitus ; Dyskinesias ; Humans ; Hyperglycemia ; Ischemia

BACKGROUND: Coenzyme Q10 is an endogenous lipid soluble antioxidant that scavenges reactive oxygen species (ROS) directly, inhibits biomolecule oxidation, and affects antioxidant defense in vivo. Kinetin (N6-furfuryladenine) belongs to the family of N6-substituted adenine derivatives known as cytokinins. Kinetin also exerts anti-aging effects. Commercial products of coenzyme Q10 and kinetin are developed and are selling as a rejuvenating drug. However, the action mechanisms of kinetin are not fully known, though it has been suggested to act both as an inhibitor of reactive oxygen species (ROS) formation and as a scavenger of ROS. Thioctic acid (alpha-Lipoic acid), which becomes a powerful antioxidant in its reduced form, has been suggested as a dietary supplement to treat diseases associated with excessive oxidant stress. Exposure of the skin to ultraviolet (UV) radiation, particulary UVB (290-320nm), causes adverse biological effects, including alterations in cutaneous immune cells, photoaging and photocarcinogenesis. Several studies have shown that coenzyme Q10, kinetin, and thioctic acid afforded the protection effects against UVB-induced inflammatory responses and photoaging. Objective and Method: In this study, we investigated the effects of coenzyme Q10, kinetin and thioctic acid on UVB irradiated human skin fibroblasts using a viability test, thiobarbituric acid assay and Northern blot analysis. RESULT: Cell survival curves after UVB irradiation showed a dose dependent decremental pattern by trypan blue exclusion assay. Only 30% of dermal fibroblasts survived at 150mJ/cm2 UVB irradiation. The damage was associated with cell membrane lipid peroxidation, as shown by accumulation malondialdehyde (MDA). By pre-cultivation with coenzyme Q10, kinetin and thioctic acid, a significant protection effect was noted as an increase in the absolute number of surviving cells and marked decrease in the levels of MDA. CONCLUSION: Coenzyme Q10, kinetin, and thioctic acid, which have been newly accepted as having UV protection properties, are effective membrane peroxidation inhibitors and inhibitors of reactive oxygen species (ROS) formation and scavenger of ROS.
Humans ; Oxidants

No abstract available.
Colorectal Neoplasms* ; Fluorouracil* ; Leucovorin*

No abstract available.
Cisplatin* ; Humans ; Nausea* ; Vomiting*

Spinal epidural and subdural hematomas are uncommonly recognized conditions. These conditions can result in severe irreversible neurologic deficits, if left untreated. Like intracranial lesions, these hematomas can expand rapidly and cause sudden spinal cord and/or cauda equina compression. This case is very rare in which is a concurrence of cervical spinal epidural and subdural hematoma after motor vehicle accident without spine fracture. The pathophysiology of these entities are discussed and the radiologic diagnosis focused on MR findings are reviewed. The importance of prompt surgical treatment is emphasized to facilitate good postoperative outcome.
Cauda Equina ; Diagnosis ; Hematoma ; Hematoma, Epidural, Spinal ; Hematoma, Subdural* ; Hematoma, Subdural, Spinal ; Motor Vehicles ; Neurologic Manifestations ; Spinal Cord ; Spine*

BACKGROUND: Memory impairment results from various neurologic disorders. Among them, the memory loss associated with stroke is called amnesic stroke. Involved regions in the amnesic stroke are medial temporal lobe, thalamus, basal forebrain, retrosplenial region, and subcortical regions. Unilateral amnesic stroke is posterior cerebral artery territory including thalamus. Isolated infarction of hippocampal region has been rarely reported because hippocampus has dual blood supply from anterior choroidal cerebral artery and posterior cerebral artery. CASE REPORT: A 61-year old male with a history of diabetes for 6 years and hypertension for 13 years, was admitted with acute memory loss occurring 6 days before admission. He could not remember the exact date, place and recent events but could remember remote events about his personal and familial affairs. Brain MRI revealed an infarction in left hippocampal region and cerebral angiography showed multiple focal stenosis and luminal irregularity on left anterior choroidal, middle cerebral, basilar and both posterior cerebral arteries. COMMENTS: We report unilateral amnesic stroke only confined to left hippocampal region with literature review.
Amnesia ; Brain ; Cerebral Angiography ; Cerebral Arteries ; Choroid ; Constriction, Pathologic ; Hippocampus ; Humans ; Hypertension ; Infarction* ; Magnetic Resonance Imaging ; Male ; Memory Disorders* ; Memory* ; Middle Aged ; Nervous System Diseases ; Phenobarbital ; Posterior Cerebral Artery ; Prosencephalon ; Stroke ; Temporal Lobe ; Thalamus

Pulsating exophthalmos, bruit, episcleral venous distention, conjunctival and (eye)lid edema, ophthalmoplegia, and ocular pain have long been regarded as the classic symptoms and signs of idiopathic dural carotid cavernous sinus fistula(CCF). We experienced a 39-year-old woman who presented with headache and cyclovertical diplopia. On neurologic examination, we found isolated left trochlear nerve palsy only. The past medical history was not remarkable. Intracranial magnetic resonance angiography revealed abnormal signals around the carotid siphon on both sides. Conventional angiography confirmed bilateral dural CCFs, leaking predominantly from the left side. Diplopia and headache had improved spontaneously over 3 weeks after the onset. Occasionally, isolated oculomotor or abducens nerve palsy has been reported as the sole clinical finding of symptomatic dural CCF. But isolated trochlear nerve palsy with dural CCF is extremely rare. Although the exact mechanisms of isolated trochlear nerve palsy by dural CCF is unclear, various mechanisms have been proposed, including compression of trochlear nerve by venous congestion or direct shunted flow in cavernous sinus, vascular steel phenomenon, and venous thrombosis.
Abducens Nerve Diseases ; Adult ; Angiography ; Carotid-Cavernous Sinus Fistula* ; Cavernous Sinus ; Diplopia ; Edema ; Exophthalmos ; Female ; Headache ; Humans ; Hyperemia ; Magnetic Resonance Angiography ; Neurologic Examination ; Ophthalmoplegia ; Steel ; Trochlear Nerve Diseases* ; Trochlear Nerve* ; Venous Thrombosis

BACKGROUND: Lymphedma occurs when tissue swelling develops through a failure of lymph drainage in the face of a normal capillary filtration. Little is known about water behavior in lymphedma. OBJECTIVE: Our purpose was to investigate, by means of ultrasound, the distribution of intradermal fluid in patients with lymphedema in response to 2 weeks physical therapy. METHODS: Ten patients with lymphedema were treated by 2 weeks' physical therapy. Before and after 2 weeks' treatment, circumference and ultrasonographic evaluation was done. Ultrasound images were obtained with a 20 MHz scanner. The echogenicity of the dermis and the skin thickness were quantified by in-built image analyzer. RESULTS: Low echogenic pixels showed the most noticeable and consistent change after 2 weeks' physical therapy. CONCLUSION: Ultrasonographic evaluation could be a useful tool in evaluating lymphedema.
Capillaries ; Dermis ; Drainage ; Filtration ; Humans ; Lymphedema* ; Skin ; Ultrasonography ; Water