The knee is a weight-bearing joint which is subjected to a great variety of static and dynamic loads. The comminuted fracture of the knee is caused by severe violent trauma, which requires well planned therapeutic procedures because of restoration of joint surface and avoidence of subsequent joint stiffness. authores have experienced 8 cases of various types of comminuted fractures of the knees at the department of orthopedic surgery, The National Medical Center, during the years from 1967 to 1972 They were analized and concluded as following. 1. The mode of the injury was considerably higher in falling type of trauma as 4 out of 8 cases Type III of comminuted fracture of the tibial plateau had higher incidence, 4 out of 5 cases and Grade III type of comminuted fracture of the femoral condyle was 2 out of 3 cases 2. 2 cases out of 8 had complicated injuries, such as peroneal nerve injuries in the Type III of comminuted fracture of the tibial condyle and meniscus injury in 1 case. 3. Conservative treatment was given to 2 cases in 1 of Group 1 and 1 of Group III type of comminuted fracture of femoral condyle, and open reduction & internal fixation was given to 6 cases with satisfactory result in all cases Average healing time was 73.5 days. 4. 1 case was complicated after operation by superficial wound infection but healed up without difficulty.
Accidental Falls ; Fractures, Comminuted ; Incidence ; Joints ; Knee ; Orthopedics ; Peroneal Nerve ; Weight-Bearing ; Wound Infection

Cerebral CT findings were described in twenty-six cases with the late sequelae of acute carbon monoxidepoisoning and were compared with the neurological symptoms and signs. The CT findins include symmetricalperiventricular white matter low density in five cases, globus pallidus low denstiy in six cases, ventriculardilatation in seven cases, ventircular dilatation and sulci widening in three cases, and normal findings in tencases. Only one case showed low densities in both periventricular white matter and globus pallidus, Late sequelaeof the interval form of carbon monoxide poisoning were clinically categorized as cortical dysfunction,parkinsonian feature, and cerebellar dysfunction. The severity of the clinical symptoms and sings of neurologialsequelae is generally correlated with presence and multiplicity of abnormal brain CT findings. But CT. Anothercase showing small unilateral low density of globus pallidus had no parkinsonian feature but showed mild corticaldysfunction.
Brain ; Brain Diseases ; Carbon Monoxide Poisoning ; Carbon Monoxide ; Carbon ; Cerebellar Diseases ; Dilatation ; Globus Pallidus ; White Matter

OBJECTIVE: Several studies have reported that periprocedural dual antiplatelet therapy lowers the incidence of thromboembolic complications (TEC) associated with coiling of unruptured aneurysms. We hypothesized that preprocedural administration of dual antiplatelet agents (aspirin and cilostazol) for 7days may reduce the risk of complications associated with diagnostic cerebral digital subtraction angiography (DSA).METHODS: We retrospectively reviewed the records of patients who underwent diagnostic cerebral DSA between September 2015 and April 2018. Of the 419 patients included (149 men, 270 women, mean age 58.5 years), 221 (72 men, 149 women, mean age 57.8 years) who underwent cerebral DSA between September 2015 and June 2016 were not premedicated with antiplatelet therapy. The remaining 198 (77 men, 121 women, mean age 59.4 years) who underwent cerebral DSA between July 2016 and April 2018 were premedicated with dual antiplatelet therapy (aspirin and cilostazol). We defined ischemic stroke as a cerebral DSA-induced complication identified on magnetic resonance imaging (MRI) among patients with neurological symptoms.RESULTS: Of the 221 patients who did not receive antiplatelet therapy, 210 (95.0%) showed no neurological symptoms; however, 11 (5.0%) developed neurological symptoms with MRI-proven ischemic stroke, which represents a TEC. Of the 198 patients who received dual antiplatelet therapy, 196 patients (99.0%) showed no evidence of TEC. The remaining 2 (1.0%) developed diplopia and motor weakness each, and MRI confirmed acute ischemic stroke (p=0.019).CONCLUSIONS: The use of dual antiplatelet agents (aspirin and cilostazol) for 7 days before DSA may reduce the risk of cerebral DSA-induced TEC.
Aneurysm ; Angiography, Digital Subtraction ; Diplopia ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Platelet Aggregation Inhibitors ; Premedication ; Retrospective Studies ; Stroke ; Thromboembolism

Aristolochia manshuriensis Kom (AMK) is an herb used as a traditional medicine; however, it causes side effects such as nephrotoxicity and carcinogenicity. Nevertheless, AMK can be applied in specific ways medicinally, including via ingestion of low doses for short periods of time. Non-alcoholic steatohepatitis (NASH) induced the hepatocyte injury and inflammation. The protective effects of AMK against NASH are unclear; therefore, in this study, the protective effects of AMK ethyl acetate extract were investigated in a high-fat diet (HFD)-induced NASH model. We found decreased hepatic steatosis and inflammation, as well as increased levels of lipoproteins during AMK extract treatment. We also observed decreased hepatic lipid peroxidation and triglycerides, as well as suppressed hepatic expression of lipogenic genes in extract-treated livers. Treatment with extract decreased the activation of c-jun N-terminal kinase 1/2 (JNK1/2) and increased the phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2). These results demonstrate that the protective effect of the extract against HFD-induced NASH occurred via reductions in reactive oxygen species production, inflammation suppression, and apoptosis related to the suppression of JNK1/2 activation and increased ERK1/2 phosphorylation. Taken together, these results indicate that that ethyl acetate extract of AMK has potential therapeutic effects in the HFD-induced NASH mouse model.
Animals ; Apoptosis ; Aristolochia* ; Diet, High-Fat ; Eating ; Fatty Liver* ; Hepatocytes ; Inflammation ; JNK Mitogen-Activated Protein Kinases ; Lipid Peroxidation ; Lipoproteins ; Liver ; Medicine, Traditional ; Mice* ; Non-alcoholic Fatty Liver Disease ; Phosphorylation* ; Phosphotransferases* ; Reactive Oxygen Species ; Therapeutic Uses ; Triglycerides

There have been several reports of gas embolism occurring during off-pump coronary artery bypass graft (OPCAB) surgery. However, all these cases of air embolism were associated with the repair of venous circulation, using a CO2 blower. In this report, we describe a rare case of air embolism in the coronary arteries associated with the use of a CO2 blower during OPCAB. There was no injury to the veins during OPCAB. The air embolism was treated successfully with cardiopulmonary bypass.
Cardiopulmonary Bypass ; Catheterization ; Coronary Artery Bypass, Off-Pump ; Coronary Vessels ; Embolism, Air ; Transplants ; Veins

Gangliosides have been suggested to play important roles in various functions such as adhesion, cell differentiation, growth control, and signaling. Mouse follicular development, ovulation, and luteinization during the estrous cycle are regulated by several hormones and cell-cell interactions. In addition, spermatogenesis in seminiferous tubules of adult testes is also regulated by several hormones, including follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and cell-cell interactions. The regulation of these processes by hormones and cell-cell interactions provides evidence for the importance of surface membrane components, including gangliosides. During preimplantation embryo development, a mammalian embryo undergoes a series of cleavage divisions whereby a zygote is converted into a blastocyst that is sufficiently competent to be implanted in the maternal uterus and continue its development. Mouse embryonic stem (mES) cells are pluripotent cells derived from mouse embryo, specifically, from the inner cell mass of blastocysts. Differentiated neuronal cells are derived from mES cells through the formation of embryonic bodies (EBs). EBs recapitulate many aspects of lineage-specific differentiation and temporal and spatial gene expression patterns during early embryogenesis. Previous studies on ganglioside expression during mouse embryonic development (including during in vitro fertilization, ovulation, spermatogenesis, and embryogenesis) reported that gangliosides were expressed in both undifferentiated and differentiated (or differentiating) mES cells. In this review, we summarize some of the advances in our understanding of the functional roles of gangliosides during the stages of mouse embryonic development, including ovulation, spermatogenesis, and embryogenesis, focusing on undifferentiated and differentiated mES cells (neuronal cells).
Animals ; *Cell Differentiation ; *Embryonic Development ; Embryonic Stem Cells/*cytology/metabolism ; Gametogenesis ; Gangliosides/*metabolism ; Mice ; Urogenital System/cytology/embryology/metabolism

BACKGROUND: Although the stapled anastomotic technique has achieved efficacy in gastrointestinal surgery, there are only a few experimental results comparing the physical properties of the anastomotic site, pathologic features of the healing process, and physiologic change after the operation. Moreover, there have been no comparative study among various stapled anastomotic techniques. The purpose of this study was to evaluate the safety of various stapled anastomotic techniques by comparing the physical properties of the anastomotic site, pathologic features of the healing process and physiologic change observed for the classical hand-sewn anastomotic technique with those observed for various stapled anastomotic techniques in the normal porcine colon and rectum. METHODS: Twelve male pigs were grouped into 4 according to the anastomotic techniques; standard Albert-Lembert two-layer hand-sewn anastomosis, stapled end-to-end anastomosis, stapled end-to-side anastomosis, and stapled side-to-side anastomosis. Each anastomotic technique was applied at 3 sites (ascending colon, transverse colon, and rectum). Groups of animals underwent a second surgery on the 4th week postoperatively, and the anastomotic properties were assessed with respect to the first day of defecation, bursting pressure, tensile strength, gross scar formation, microscopic inflammatory cell infiltration, telangiectasia, lymphangiectasia, foreign-body reaction, granulation and fibrosis. RESULTS: No significant difference among the respective anastomotic techniques was found with respect to the first day of defecation, bursting pressure, tensile strength, microscopic inflammatory cell infiltration, telangiectasia, and lymphangiectasia. However, more scar formation, foreign-body reaction, granulation and fibrosis were observed in the hand-sewn anastomosis. There was no significant difference among the groups of various stapled anastomotic techniques. CONCLUSION: According to this animal study, various stapled anastomoses were superior to the standard Albert-Lembert two-layer hand-sewn anastomosis with less scar formation, foreign-body reaction,granulation and fibrosis. In colorectal surgery, various stapled anastomotic techniques can be safely applied in accordance with the respective purpose and the anatomical characteristics.
Animals ; Breast Neoplasms* ; Breast* ; Cicatrix ; Colon* ; Colon, Transverse ; Colorectal Surgery ; Defecation ; Fibrosis ; Foreign-Body Reaction ; Humans ; Lymphatic Vessels ; Male ; Mastectomy ; Mastectomy, Radical ; Mastectomy, Segmental* ; Neoplasm Metastasis ; Rectum ; Recurrence ; Retrospective Studies ; Swine ; Telangiectasis ; Tensile Strength

The human colorectal carcinoma-associated GA733 antigen epithelial cell adhesion molecule (EpCAM) was initially described as a cell surface protein selectively expressed in some myeloid cancers. Gangliosides are sialic acid-containing glycosphingolipids involved in inflammation and oncogenesis. We have demonstrated that treatment with anti-EpCAM mAb and RAW264.7 cells significant inhibited the cell growth in SW620 cancer cells, but neither anti-EpCAM mAb nor RAW264.7 cells alone induced cytotoxicity. The relationship between ganglioside expression and the anti-cancer effects of anti-EpCAM mAb and RAW264.7 was investigated by high-performance thin-layer chromatography. The results demonstrated that expression of GM1 and GD1a significantly increased in the ability of anti-EpCAM to inhibit cell growth in SW620 cells. Anti-EpCAM mAb treatment increased the expression of anti-apoptotic proteins such as Bcl-2, but the expression of pro-apoptotic proteins Bax, TNF-alpha, caspase-3, cleaved caspase-3, and cleaved caspase-8 were unaltered. We observed that anti-EpCAM mAb significantly inhibited the growth of colon tumors, as determined by a decrease in tumor volume and weight. The expression of anti-apoptotic protein was inhibited by treatment with anti-EpCAM mAb, whereas the expression of pro-apoptotic proteins was increased. These results suggest that GD1a and GM1 were closely related to anticancer effects of anti-EpCAM mAb. In light of these results, further clinical investigation should be conducted on anti-EpCAM mAb to determine its possible chemopreventive and/or therapeutic efficacy against human colon cancer.
Animals ; Antibodies, Monoclonal/*immunology/*therapeutic use ; Antigens, Neoplasm/*immunology ; Apoptosis/drug effects ; Cell Adhesion Molecules/*immunology ; Cell Line ; Cell Line, Tumor ; Cell Proliferation/drug effects ; Colon/drug effects/immunology/metabolism/pathology ; Colonic Neoplasms/*drug therapy/genetics/*immunology/pathology ; Gangliosides/genetics/*immunology ; Gene Expression Regulation, Neoplastic/drug effects ; Humans ; Male ; Mice ; Mice, Inbred BALB C

Glycosphingolipids including gangliosides play important regulatory roles in cell proliferation and differentiation. UDP-glucose:ceramide glucosyltransferase (Ugcg) catalyze the initial step in glycosphingolipids biosynthesis pathway. In this study, Ugcg expression was reduced to approximately 80% by short hairpin RNAs (shRNAs) to evaluate the roles of glycosphingolipids in proliferation and neural differentiation of mouse embryonic stem cells (mESCs). HPTLC/immunofluorescence analyses of shRNA-transfected mESCs revealed that treatment with Ugcg-shRNA decreased expression of major gangliosides, GM3 and GD3. Furthermore, MTT and Western blot/immunofluorescence analyses demonstrated that inhibition of the Ugcg expression in mESCs resulted in decrease of cell proliferation (P < 0.05) and decrease of activation of the ERK1/2 (P < 0.05), respectively. To further investigate the role of glycosphingolipids in neural differentiation, the embryoid bodies formed from Ugcg-shRNA transfected mESCs were differentiated into neural cells by treatment with retinoic acid. We found that inhibition of Ugcg expression did not affect embryoid body (EB) differentiation, as judged by morphological comparison and expression of early neural precursor cell marker, nestin, in differentiated EBs. However, RT-PCR/immunofluorescence analyses showed that expression of microtubule- associated protein 2 (MAP-2) for neurons and glial fibrillary acidic protein (GFAP) for glial cells was decreased in neural cells differentiated from the shRNA-transfected mESCs. These results suggest that glycosphingolipids are involved in the proliferation of mESCs through ERK1/2 activation, and that glycosphingolipids play roles in differentiation of neural precursor cells derived from mESCs.
Animals ; *Cell Proliferation ; Cells, Cultured ; Down-Regulation ; Embryonic Stem Cells/*cytology/metabolism ; Glucosyltransferases/genetics/metabolism ; Glycosphingolipids/genetics/*metabolism ; Mice ; Mitogen-Activated Protein Kinases/metabolism ; *Neurogenesis ; Neurons/*cytology/metabolism ; RNA, Messenger/genetics

No abstract available.