No abstract available.
Animals ; Atrophy* ; Electric Stimulation* ; Muscle, Skeletal* ; Rats* ; Sciatic Nerve*

A cardiovascular collapse, due to preoperatively administered intravenous vitamin K (phytonadione), was experienced in a 59-year-old woman who was scheduled to undergo a left upper lung lobectomy. The patient developed sudden facial flushing, an upper torso rash, dyspnea, palpitation, and severe hypotension about 2 min after the intravenous administration of approximately 2 mg of vitamin K. Immediate hydration and an injection of 20 mg ephedrine restored her blood pressure to the preoperative level within 5 min. The patient recovered without any sequelae, but the operation was postponed. The patient's symptoms seemed to be due to an anaphylactoid reaction or anaphylaxis following the intravenous administration of vitamin K. This case report suggests that physicians should carefully review the indications of vitamin K prior to administration, even at low doses.
Administration, Intravenous ; Anaphylaxis ; Blood Pressure ; Dyspnea ; Ephedrine ; Exanthema ; Female ; Flushing ; Humans ; Hypotension ; Lung ; Middle Aged ; Torso ; Vitamin K ; Vitamins*

The cutaneous synthesis of vitamin D in response to ultraviolet radiation exposure is the most important factor in maintaining vitamin D balance in Man. The skin is not only the site of vitamin D synthesis, but also a target organ for calcitriol(1, 25-dihydroxy-vitamin D) which is naturally occuriag, hormonally active form of vitamin E. It is now known that calcitriol inhibits the proliferation of epidermal cells and induces her differentiation. In this study, epidermal keratinocytes and melanocytes were isilated from the neonatal foreskin, and were culturod using a MCDB 153 and modified TIC media, respectively. And then various concentratioris of calcipotriol(MC 903), a synthetic aralogue of calcitriol, were added to each culture. The effects of calcipotriol on the growth of human keratinocytes and melanocytes were investigated. The results were as follows : 1. The addition of calopotriol to human keratinocyte and melalocyte cultures inhibited their proliferation in a dosdependent manner. 2. Calcipotriol had no effects on the melanization process of the melanocyte. 3. Calcipotriol was found to inhibit the proliferation, however it induced the terminal differentiation of cultured keratinocytes, as judged by morphologicai changes. The decreased density of kerationcytes, The formation of cornified cells, and the cellular destruction in a concentration of 10 M of calcipotriol were observed. 4. By using the light atid the electron microscope, we observed that the epidermal thickness was decreased and terminal differentiation was facilitateir. Living Skin Equivalent (LSE) according to the increasing concentration of calcipotriol. A]i)parent cytotoxic effects were observed in 10 M, 10 M of calcipotriol. In summary, the above results indicate that the addition of calcipotriol to the in vitro culture system of human keratinocyte and melanocyte induces the biologic process of terminal differentiation of keratinocytes and inhibits proliferation of keratinoytes and melanocytes in a dose-dependent manner.
Calcitriol ; Cholecalciferol* ; Foreskin ; Humans* ; Keratinocytes* ; Melanocytes* ; Skin ; Tics ; Vitamin D ; Vitamin E ; Vitamins*

The trematode Paramphistomum cervi empolyed in this experiment was obtained from the reticulum of cattle slaughtered at the local abbatoir. The worms were selected and washed several times in normal sterilized saline solution. Each about ten of intact worms were incubated in 50 cc volume of special incubation flasks with incubation mixture consisting of 50 cc of Krebs-Ringer phosohate buffer (pH 7.4) to which were added universally labeled C(14)-glucose and non-radioactive carrier glucose concentration of 200 mg per cent. The worms were allowed to incubate for 3 hours in the incubator at 38 C. After incubation period, respiratory CO(2) samples from central wall of incubation flask were analysed for total CO(2) production rate and their specific activity of respiratory CO(2). Glycogen samples isolated from worms were analysed for the tissue concentration and their radioactivities in order to determine the turnover rate of glycogen pool. The glucose uptake rate was determined by analysing the difference of the glucose concentration in a medium before and after incubation period. Radioactivities of these series of experiments were counted by an endwindow Geiger-Muller counter as an infinitely thin samples. The quantitative analysis of C(14)-glucose utilized by Paramphistomum cervi was summerized as the following. The glucose uptake rate by Paramphistomum was a mean value of 2.32+/-0.27 micro-mole/hr/g of wet wt. and total CO(2) production rate by the worms averaged 10.85+/-0.41 micro-mole/hr/g of wet wt. The relative specific activities of respiratory CO(2) averaged 49.72+/-13.20 per cent. Thus, a mean of 49.72 per cent of total CO(2) production rate was originated from the glucose in the medium, therefore the rate of CO(2) production derived from medium glucose was mean of 5.24+/-2.16 micro-mole/hr/g of wet wt. Thus, the average value of 37.46+/-5.28 per cent of glucose utilized by the worms from the medium glucose was oxidized to respiratory CO(2). The tissue concentration of Paraphismum was a mean of 41.56+/-5.82 micro-mole/hr/g of wet wt or 4.16+/-0.72 per cent/g , and the turnover rate of glycogen pool yielded with a mean of 0.12+/-0.014 percent/hr or 0.06+/-0.04 mg/hr/g of wet wt. Therefore, a mean value of 16.75+/-4.84 per cent of glucose was incorporated to the glycogen. These data account for that at least 54.21 per cent of the utilized glucose by the worms participated in furnishing the oxidation into respiratory CO(2) and the synthetic process into glycogen. According to the above data of the experiment, it is suggested in the metabolic process of glucose by the Paramphistomum that the synthetic process into the glycogen is less active than the oxidative process into the resppiratory CO(2).
parasitology-helminth-trematoda ; Paramphistomum cervi ; autoradiography ; biochemistry ; glucose ; metabolism ; CO(2) ; glycogen

Fracture of the tibial shaft is one of the most common fractures of the long bones and frequently followed by malunion, delayed union and nonunion. We experienced the cases of further increase in the angulation after clinical union of the tibial shaft fractures treated by conservative method. So we analyzed 39 cases of tibial shaft fractures which were followed up from 12 weeks to 37 weeks after clinical union in adults. The results were as follows; l. 7 of the 39 cases(18%) showed the increase in the angulation, and all of them were male. 2. Increase in the angulation occurred more frequenlty in the comminuted fractures than simple fractures. 3. The increment of angulation was more marked in group of patients with higher angulation at the time of clinical union. 4. Increase in the angulation occurred more commonly in the cases not associated with fibula fracture than in the cases associated with fibula fracture. 5. Further increase in the angulation was less common in the cases in whom early weight bearing with PTB cast was started.
Adult ; Fibula ; Fractures, Comminuted ; Humans ; Male ; Methods ; Tibia ; Weight-Bearing

PURPOSE: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). MATERIALS AND METHODS: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. RESULTS: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%). CONCLUSION: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.
Academic Medical Centers ; Disease-Free Survival ; Extremities ; Follow-Up Studies ; Humans ; Korea ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Treatment Outcome

OBJECTIVE: We report a case with a long-standing history of the ankylosing spondylitis(AS) who showed multiple cerebellar infarctions with bulbar symptom owing to vertebral artery obstruction, due to anterior and vertical subluxation of atlanto-axial and atlanto-occipital joint. CLINICAL PRESENTARION: An 51-year-old male patient with swallowing difficulty, tongue deviation to the left side and severe nuchal pain and rigidity is presented. INTERVENTION: After removal of posterior portion of foramen magnum, posterior portion of left transverse foramen of axis was decompressed. CONCLUSIONS: Spontaneous anterior atlanto-axial subluxation occurs in patients with AS about 2% of presents with or without signs of spinal cord compression. Vertical subluxation occurs in 3-8% of patient with rheumatoid arthritis but it is an exceedingly rare complication of AS. Close observation and follow-up are needed in patients with AS and if subluxation occurs, good prognosis is anticipated using an early operative treatment.
Arthritis, Rheumatoid ; Atlanto-Occipital Joint* ; Axis, Cervical Vertebra ; Deglutition ; Follow-Up Studies ; Foramen Magnum ; Humans ; Infarction ; Male ; Middle Aged ; Prognosis ; Spinal Cord Compression ; Spondylitis, Ankylosing* ; Tongue ; Vertebral Artery*

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*

PURPOSE: This study analyzed the difference in survival time of patients with delirium according to sedative medication. METHODS: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. RESULTS: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=−3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). CONCLUSION: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.
Busan ; Cohort Studies* ; Delirium* ; Drug Therapy ; Electronic Health Records ; Haloperidol ; Humans ; Hypnotics and Sedatives ; Mass Screening ; Retrospective Studies* ; Survival Rate ; Terminally Ill*

BACKGROUND: MAGE(melanoma antigen gene) has been named as cancer/testis specific antigens since its expression is only detected in the testis or cancer cells. Because of its relatively specific expression in cancer cells, it has been considered as a marker for the early diagnosis of several cancers, or as an appropriate target for a specific immunotherapy mediated by cytotoxic T lymphocytes. Therefore, there have been many reports concerning the expression of MAGE genes in various types of malignant tumors, although only a few reports in human thyroid neoplasms. The purpose of this study was to determine whether the MAGE-1, -2, -3, -4, -5, and -10 genes expressed in different histological types of thyroid tumors and to elucidate the clinical usefulness of MAGE genes on the diagnosis of thyroid tumors. METHODS: Thirty-eight patients who had undergone thyroidectomy at Kosin Medical Center between January and August, 1999 were included in the study. Of the 38 patients enrolled, 26 exhibited papillary carcinoma, 3 papillary carcinoma with lymph node metastasis, 1 follicular carcinoma, 1 medullary carcinoma, 5 nodular hyperplasia, 1 adenomatous goiter, and 1 follicular carcinoma. In the twelve normal control thyroid tissues, total cellular mRNA was extracted from 31 cancer tissues and 7 benign tissues, RT-PCR was run in 35 cycles, with specific primers of the subtypes of MAGE genes. With probes confirmed by DNA sequencing, the isolates were reevaluated by Southern blot hybridization. RESULTS: In the 26 papillary carcinomas, MAGE-1,-2,-3,-4,-5 and -10 genes were expressed in 88.5%, 92.3%, 3.8%, 26.9%, 26.9%, and 0% by RT-PCR respectively. In the three papillary carcinomas with regional lymph node metastasis, MAGE-1, -2 and -5 genes expressed in two of the three, and MAGE-4 in one of the three cases. In the one medullary carcinoma, the MAGE-1,-2,-4, and MAGE-5 genes were expressed, and in the one case of follicular carcinoma, only the MAGE-2 gene was expressed. In contrast, none of the 7 benign tumors and 12 normal control tissues expressed any of these MAGE genes. The sensitivity of MAGE-1,-2,-3,-4,-5 and -10 genes in thyroid tumors was 83.8%, 90.3%, 3%, 29.0%, 32.3%, and 0%, respectively and the specificity was 100%. CONCLUSION: These results demonstrate that MAGE genes were expressed in the malignant thyroid tumors but not in the benign tumors and normal tissues. Among the MAGE gene families, MAGE-1 and -2 genes were more sensitive than MAGE-3, 4,-5 and -10 genes. However, in order to demonstrate if the MAGE genes could be used for the diagnosis of follicular carcinoma and distant metastasis in thyroid tumors, further study is required.
Blotting, Southern ; Carcinoma, Medullary ; Carcinoma, Papillary ; Diagnosis ; Early Diagnosis ; Goiter ; Humans ; Hyperplasia ; Immunotherapy ; Lymph Nodes ; Neoplasm Metastasis ; RNA, Messenger ; Sensitivity and Specificity ; Sequence Analysis, DNA ; T-Lymphocytes, Cytotoxic ; Testis ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy