The lesser trochanteric fracture is commonly found amongst intertrochanteric fractures, where pseudoaneurysm of the femoral artery is a rare complication. A pseudoaneurysm could develop due to the penetration injury of the artery by the bone fragment during occurrence of the fracture, or by the insertion of screws during the surgical procedure. Minimal complication is seen when the lesser trochanter is not fixed during the intertrochanteric fracture surgery. However, in the current case, the authors experienced appearance of a delayed pseudoaneurysm of the deep femoral artery caused by migration of the lesser trochanter, which was successfully treated by excision.

The lesser trochanteric fracture is commonly found amongst intertrochanteric fractures, where pseudoaneurysm of the femoral artery is a rare complication. A pseudoaneurysm could develop due to the penetration injury of the artery by the bone fragment during occurrence of the fracture, or by the insertion of screws during the surgical procedure. Minimal complication is seen when the lesser trochanter is not fixed during the intertrochanteric fracture surgery. However, in the current case, the authors experienced appearance of a delayed pseudoaneurysm of the deep femoral artery caused by migration of the lesser trochanter, which was successfully treated by excision.

Central pontine and extrapontine myelinolysis are well-recognized osmotic demyelination syndromes related to the rapid correction of hyponatremia, chronic alcoholism, and malnutrition. They are reported to show brain stem signs and various movement disorders. A 58-year-old man with a history of chronic alcoholism was admitted for dysarthria, dysphagia, and gait disturbance that had developed five days after a right forearm cellulitis. Magnetic resonance imaging revealed demyelinating patterns in the central portion of the pons and both thalami. He showed severe extrapyramidal symptoms with truncal swaying and postural instability that resulted in severe gait disturbance. Postural instability showed little improvement after conventional physical therapy, but his symptoms markedly improved after five days of dopamine administration. Cessation of dopamine agents was attempted two times, but postural instability and gait disturbance recurred. Therefore, medication was continued for one year. The patient showed stable gait and no further deterioration of postural instability during dopamine therapy.
Alcoholism ; Brain Stem ; Cellulitis ; Deglutition Disorders ; Demyelinating Diseases ; Dopamine ; Dopamine Agents ; Dysarthria ; Follow-Up Studies* ; Forearm ; Gait ; Humans ; Hyponatremia ; Magnetic Resonance Imaging ; Malnutrition ; Middle Aged ; Movement Disorders ; Myelinolysis, Central Pontine* ; Pons

STUDY DESIGN: A retrospective study. PURPOSE: To analyze the treatment outcome of patients with lower thoracic and lumbar fractures combined with neurological deficits. OVERVIEW OF LITERATURE: Although various methods of the surgical treatment for lower thoracic and lumbar fractures are used, there has been no surgical treatment established as a superior option than others. METHODS: Between March 2001 and August 2009, this study enrolled 13 patients with lower thoracic and lumbar fractures who underwent spinal canal decompression by removing posteriorly displaced bony fragments via the posterior approach and who followed up for more than a year. We analyzed the difference between the preoperative and postoperative extents of canal encroachment, degrees of neurologic deficits and changes in the local kyphotic angle. RESULTS: The average age of the patients was 37 years. There were 10 patients with unstable burst factures and 3 patients with translational injuries. Canal encroachment improved from preoperative average of 84% to 9% postoperatively. Local kyphosis also improved from 20.5degrees to 1.5degrees. In 92% (12/13) of the patients, neurologic deficit improved more than Frankel grade 1 and an average improvement of 1.7 grade was observed. Deterioration of neurologic symptoms was not observed. Although some loss of reduction of kyphotic deformity was observed at the final follow-up, serious complications were not observed. CONCLUSIONS: When posteriorly displaced bony fragments were removed by the posterior approach, neurological recovery could be facilitated by adequate decompression without serious complications. The posterior direct decompression could be used as one of treatments for lower thoracic and lumbar fractures combined with neurologic injuries.
Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Neurologic Manifestations ; Retrospective Studies ; Spinal Canal ; Treatment Outcome

BACKGROUND AND OBJECTIVES: Retinoids have been used in chemoprevention trials for a variety of epithelial malignancies. However, high incidence of toxicity and drug resistance remains as problems. Increase of the retinoid metabolism by cytochrome P450 has been known as one of the several mechanisms explaining these toxicity and the aquired resistance. There have been many studies about the biological effects of retinoids in head and neck squamous cell carcinoma (HNSCC), but there is no information about the effects of the retinoids metabolism on cell biology. The study presented here is designed to examine the relationship between cytochrome P450 induction and responses to retinoids in the HNSCC cell lines. MATERIAL AND METHODS: We used a human HNSCC cell lines (AMC-HN-4, AMC-HN-6). The change of metabolic activity was analyzed using thin layer chromatography (TLC). The effects of retinoids on cell proliferation were evaluated with CellTiter 96 TMAQueous Cell Proliferation Assay. The effects of retinoids on beta4 integrin expression were evaluated with flow cytometry. RESULTS: The inhibitory effects of retinoids on cell proliferation were higher in AMC-HN-4 cell line (cytochrome P450 uninducible) than in AMC-HN-6 cell line (cytochrome P450 inducible) (p<0.05). The expression of beta4 integrin was more effectively suppressed in the AMC-HN-4 cell line than in the AMC-HN-6 cell line. CONCLUSION: The results of this study suggest that cytochrome P450 inducilbility may be an important factor to determine the biological effects of retinoids in HNSCC cells.
Carcinoma, Squamous Cell* ; Cell Line* ; Cell Proliferation ; Chemoprevention ; Chromatography, Thin Layer ; Cytochrome P-450 Enzyme System ; Drug Resistance ; Flow Cytometry ; Head* ; Humans ; Incidence ; Integrin beta4* ; Metabolism ; Neck* ; Retinoids*

Methods: Radiograms of the 11 study subjects (six men and five women), aged 22–90 years who visited the outpatients’ clinic for various neck complaints without trauma history were examined. C4–5 synostosis was an incidental finding in all the subjects. Results: All the fused bodies were inwaisted and had anterior caudal breaking but no interior corporal flaring. Adjacent segment disease was not found in eight patients aged <40 years. Disk degeneration was found at C3–4 and C5–6 in three patients each and at C6–7 in two patients. Disk degeneration was limited to the adjacent segments. Conclusions Degenerative disk changes are associated with the natural aging process, and the corporal morphology of the fused vertebral becomes inwaisted similar to that in the single vertebrae.

Methods: Radiograms of the 11 study subjects (six men and five women), aged 22–90 years who visited the outpatients’ clinic for various neck complaints without trauma history were examined. C4–5 synostosis was an incidental finding in all the subjects. Results: All the fused bodies were inwaisted and had anterior caudal breaking but no interior corporal flaring. Adjacent segment disease was not found in eight patients aged <40 years. Disk degeneration was found at C3–4 and C5–6 in three patients each and at C6–7 in two patients. Disk degeneration was limited to the adjacent segments. Conclusions Degenerative disk changes are associated with the natural aging process, and the corporal morphology of the fused vertebral becomes inwaisted similar to that in the single vertebrae.

Acute pancreatitis caused by eosinophilic gastroenteritis is a rare disease, and little has been reported so far. Diagnosing eosinophilic gastroenteritis is difficult because the symptoms and laboratory findings are not specific. We report a rare case of eosinophilic gastroenteritis related to acute pancreatitis as a possible cause of idiopathic acute pancreatitis. A 61-year-old man visited the hospital complaining of epigastric pain. Although no pancreatic abnormalities were confirmed on imaging studies, the patient showed hyperamylasemia and hyperlipasemia. Serum eosinophil fractions were initially normal. However, they were elevated on follow-up examinations, and a large number of eosinophils were observed in the biopsies of the stomach and duodenum, which led to the diagnosis of eosinophilic gastroduodenitis related to acute pancreatitis.

OBJECTIVE: Histopathologic evaluation has been used to evaluate the degree of hepatic fibrosis. This method may have limitations because percutaneous liver biopsy is invasive and histopathologic change shows heterogenicity in the liver. It has been reported that the biochemical markers may have an important role in evaluating the degree of hepatic fibrosis. This study was performed to evaluate the clinical significances of serum hyaluronic acid (HA) and type IV collagen (IV-C) levels on hepatic fibrosis in the patients with chronic viral hepatitis B and liver cirrhosis. METHODS: This study included fifty eight patients with chronic viral liver diseases caused by HBV. Scheuer's classification was used to determine the degree of hepatic fibrosis. The levels of hyaluronic acid and type IV collagen was evaluated by one-step sandwich binding protein assay and one-step sandwich enzyme immunoassay respectively. RESULTS: The level of hyaluronic acid and type IV collagen in stage III (HA:589.4+/-193.7ng/ml, IV-C:444.5+/- 221.3ng/ml) and IV (727.5+/-306.1ng/ml, IV-C:519.2+/-210.5 ng/ml) were higher than stage I (HA:207.2+/-206.8ng/ml, IV-C:210.0+/-92.0ng/ml) and II (HA:223.7+/-172.9ng/ml, IV- C:209.6+/-70.7ng/ml) in the patients with chronic viral hepatitis and cirrhosis. At cutoff value of 500ng/ml for HA and 250ng/ml for IV-C in chronic hepatitis B patients, the sensitivities were 85% and 85%, and specificities were 89.5% and 78.9%, and diagnostic efficiencies were 87.9% and 81% respectively for discriminating patients with advanced hepatic fibrosis (stageIII-IV) from those with mild hepatic fibrosis (stageI-II). CONCLUSION: The serum levels of hyaluronic acid and type IV collagen correlated significantly with the degree of hepatic fibrosis in the patients with chronic viral hepatitis B and cirrhosis. The serum hyaluronic acid and type IV collagen is useful biochemical markers for evaluating hepatic fibrosis and follow up of the patients with chronic viral hepatitis B and cirrhosis.
Biomarkers ; Biopsy ; Carrier Proteins ; Classification ; Collagen Type IV* ; Fibrosis ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Hyaluronic Acid* ; Immunoenzyme Techniques ; Liver Cirrhosis* ; Liver Diseases ; Liver*

BACKGROUND: Although maximal exercise stress tests are widely used in the athletic and medical fields, studies on professional soccer players are few. The purpose of our study is to observe the cardiopulmonary response to maximal exercise loading and the AT in professional soccer players. METHODS: Maximal exercise stress tests were carried out by a ramp protocol using a treadmill on 20 professional soccer players with a mean age of 25.2 years and with over 10 career years. The tests were also done on 21 college students majoring in physical education with a mean age of 19.4 years, which served as the control group. The AT was determined by the V-slope method. RESULTS: In the players, the VO2 max, VCO2 max and O2 pulse max were significantly larger than those in the control group, and the HR max was smaller for their ages. The VE max, VT max and RP max showed not much difference between the 2 groups but the VE max/VO2 max and VE max/VCO2 max were significantly lower in the players. The AT was larger in the players but the AT/VO2 max was essentially similar to that of the control group. CONCLUSION: Our study reveals that the professonal soccer players, despite their mean ages were approximately 6 years older than the subjects in the control group, had larger VO2 max and VCO2 max, and smaller HR max for their ages. The VE max was similar in both groups. This suggests that the players have higher aerobic capacity than the control group and exchange respiratiory gases more efficiently.
Architectural Accessibility ; Child ; Exercise Test ; Gases ; Humans ; Physical Education and Training ; Soccer* ; Sports