No abstract available.
Aneurysm* ; Renal Artery*

A survey of the literature on the treatment of ruptures of deltoid ligament associated with fracture of distal part of fibula is controversial. Some authors advocated surgical repair of the ruptured deltoid ligament based on the theoretical consideration, while others advocated non-operative treatment based on the clinical consideration. We studied the results in forty-five patients who were treated for disruption of the deltoid ligament and a distal fibular fracture. The length of follow-up in our series was twelve to twenty-four months, with an average of fifteen months. When the fibular fracture was adequately reduced and medial clear space was returned to its normal width, the 91 percents both of patients of being treated with repair of deltoid ligament and patients of being treated without repair had a good or excellent results.
Clinical Study ; Fibula ; Follow-Up Studies ; Humans ; Ligaments ; Rupture

Treatment methods of unicompartmental osteoarthritis of knee joint are arthroscopy, osteotomy, unicompartmental arthroplasty, and total arthroplasty. Among them the rate of unicompartmental arthroplasty is increased and many complications are reported recently. Polyethylene wear and component loosening, and infection are the common failure mechanism, but dislocation of meniscal polyethylene is rare, and not reported. So we report the case of the dislocation of polyethylene and study the cause and preventive method.

Since Steeg, et al.(1988) identified NM23/NDP kinase as non -metastasis gene, other multiple functions of have reported. One of them, Postel, et al.(1993) suggested that transcription factor PuF, being encoded by NM23 -H2/NDP kinase gene, interacts with nuclease hypersensitive element located upstream of the c -myc gene. C -myc amplification and activation can be present in squamous cell carcinoma of the head and neck as well as in an increased metastatic propensity for individual tumor. To clarify the role of NM23/NDP kinase on c -myc expression, comparison of these two gene expressions in cell lines was done. No direct correlation of expression kinetics was found. A plasmid containing human c -myc fragment was cloned upstream of chloramphenicol acetyltransferase (CAT) gene. When murine melanoma cell line was cotransfected with a murine NM23 -M2 including expression vector and c -myc CAT, CAT activity was elevated, while no change of CAT activity was found in the cotransfectant of human NM23 -H2 and c -myc CAT. Data suggest that murine NM23 -M2 gene transactivates c -myc gene indirectly with a cellular factor in murine cell line which dose not work with human NM23 -H2 gene. Additionally, we found same kinetics of NM23 -H2/NDP kinase and c -myc expression change correlated with proliferation of PLC/PRF/5 which was induced by HGF.
Animals ; Carcinoma, Squamous Cell ; Cats ; Cell Line* ; Chloramphenicol O-Acetyltransferase ; Clone Cells ; Gene Expression ; Head ; Humans ; Kinetics ; Melanoma ; Neck ; Phosphotransferases* ; Plasmids ; Transcription Factors ; Transcriptional Activation

BACKGROUND: Prostacyclin administered intravenously has demonstrated intermediate pulmonary specificity and its aerosol form has an even greater pulmonary selectivity. There have been few systematic analyses of the difference in response according to the route of administration and the dose of administration of prostacyclin. So we have compared prostacyclin infusion versus inhalation in various concentrations in an animal model. METHODS: Pulmonary hypertension was induced by continuous intravenous infusion of the vasoconstrictor U46619 and prostacyclin solutions of 10, 50, 100, 200 mcg/ml were inhaled using a jet nebulizer. Prostacyclin infusion was done at a rate of 100, 200, 400 ng/kg/min. RESULTS: With inhalation of 10, 50, 100, 200 mcg/ml prostacyclin, PVR fell to values of 85%, 76%, 64%, 55% of the preinhalation value and SVR fell to values of 94%, 80%, 76%, 64% of the preinhalation value, respectively (p<0.05). PVR/SVR ratios decreased significantly in all inhalation doses (p<0.05). With infusion of prostacyclin at a rate of 100, 200, 400 ng/kg/min, PVR fell to values of 73%, 60%, 50% of the preinfusion value and SVR fell to values of 68%, 54%, 38% of the preinfusion value, respectively (p<0.05). PVR/SVR ratios increased at an infusion rate of 400 ng/kg/min. CONCLUSION: Prostacyclin inhalation did not result in selective pulmonary vasodilation without causing any efects on the systemic vascular bed (absolute pulmonary selectivity). But it did cause more predominant vasodilation on the pulmonary vascular bed (relative pulmonary selectivity). By contrast, prostacyclin infusion caused more predominant vasodilation on the systemic vascular bed, creating the risk of severe systemic hypotension.
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid ; Epoprostenol* ; Hypertension, Pulmonary* ; Hypotension ; Infusions, Intravenous ; Inhalation ; Models, Animal ; Nebulizers and Vaporizers ; Sensitivity and Specificity ; Vasodilation

STUDY DESIGN: A retrospective analysis study of the long term clinical results of microscopic discectomy. OBJECTIVES: To evaluate clinical outcome of microscopic lumbar discectomy at the 10 year postoperative follow up SUMMARY OF LITERATURE REVIEW: There have been frequent reports of short term follow up studies for microscopic lumbar discectomies, but in there have been few long term follow-up studies reported in the literature. (Please confirm the highlighted section; before it was incomplete, so I have tried to complete for you.) MATERIALS AND METHODS: A ten year follow-up study was possible in 40 out of the 101 patients diagnosed with a lumbar disc herniation and treated with a microscopic discectomy between January 1992 and December 1993. Recurrent HIVD (Define?), followed by a microscopic discectomy, was evaluated using Kim's criteria. Also, the effects of smok0ing prohibition and rehabilitation exercise programs on recurrence were investigated. RESULTS: Among the 101 patients having undergone an operation, 5 and 10 year follow ups were performed in 83 (82.2%) and 40 cases (39.6%), respectively. Loss to follow-up was mostly due to changes of address and in the contact-list. 33 cases (84.6%) showed more than fair recovery after 5 years, with 33 cases (82.5%) showing similar results after 10 years. Postoperative smoking prohibition and exercise programs for the prevention of a recurrence were carried out on 32 cases (80%), with 2 of these cases (6.3%) showing recurrence compared with 5 cases (62.5%) in the non-control group. CONCLUSION: Postoperative smoking prohibition and rehabilitation exercise programs were useful and are recommended for lumbar disc herniation patient following a microscopic discectomy. Also, early return of the patient to their previous work could decrease the potential recurrence rate.
Diskectomy* ; Follow-Up Studies* ; Humans ; Recurrence ; Rehabilitation* ; Retrospective Studies ; Smoke* ; Smoking*

This study aimed to develop a UPLC-MS/MS method for determining plasma levels of L-aspartic acid and L-asparagine and the activity of L-asparaginase. L-aspartic acid, L-asparagine, and L-aspartic acid-2,3,3-d3 were extracted from human plasma by protein precipitation with sulfosalicylic acid (30%, v/v). The plasma samples were analyzed using an Imtakt Intrada amino acid analysis column with 25 mM ammonium formate and 0.5% formic acid in acetonitrile as the mobile phase with step gradient method at a flow rate of 0.5 mL/min. The injection volume was 5 µL, and the total run time was 15 min. Inter- and intra-batch accuracies (%) ranged from 96.62–106.0% for L-aspartic acid and 89.85–104.8%, for L-asparagine, and the coefficient of variation (CV%) did not exceed 7%. The validation results for L-aspartic acid and L-asparagine satisfied the specified criterion, however, the results for L-asparaginase activity assay showed a borderline validity. This study could be a foundation for further development of therapeutic drug monitoring systems using UPLC-MS/MS.
Ammonium Compounds ; Asparagine ; Aspartic Acid ; Drug Monitoring ; Humans ; Methods ; Plasma

Generalized vitiligo associated with allogeneic bone marrow or stem cell transplantation has rarely been reported. We experienced two cases of generalized vitiligo after allogeneic bone marrow and stem cell transplantation. The first patient was received an allogeneic bone marrow transplantation and subsequent allogeneic peripheral blood stem cell transplantation for severe aplastic anemia from his sister. The second patient underwent allogeneic bone marrow transplantation for acute myelogeneous leukemia from his sister. Generalized vitiligo developed after transplantation. Neither vitiligo nor evidences of autoimmune diseases were found in their stem cell donors. Vitiligo was effectively treated with narrow band UVB irradiation.
Anemia, Aplastic ; Autoimmune Diseases ; Bone Marrow ; Bone Marrow Transplantation ; Humans ; Leukemia ; Peripheral Blood Stem Cell Transplantation ; Siblings ; Stem Cell Transplantation* ; Stem Cells* ; Tissue Donors ; Vitiligo*

BACKGROUND: Eltrombopag is a thrombopoietin receptor agonist with excellent treatment outcomes in immune thrombocytopenia (ITP). Here, we analyzed the dose of eltrombopag required to achieve and maintain safe platelet counts in Korean ITP patients. METHODS: Adult refractory ITP patients (<30,000 platelets/microL) were enrolled. Eltrombopag doses were increased to achieve a target platelet count (> or =50,000 cells/microL). After achieving the target platelet count, the dose of concomitant ITP medications and eltrombopag was reduced to identify the lowest effective dose required to maintain the platelet count. RESULTS: Among 18 patients, 66.7% achieved complete response, 5.6% achieved platelet counts between 50,000 and 100,000 cells/microL, and 27.8% failed to achieve the target platelet count. The median ITP duration was significantly shorter in patients who achieved the target platelet count. The initial dose required to achieve the target platelet count was 25 mg/d. The adjusted maintenance doses were 25 mg twice per week or 25 mg/d. After discontinuation, 83.3% relapsed, and the median relapse-free survival was 15 days. Two relapsed and 1 failed patient switched to romiplostim. The response to romiplostim was similar to eltrombopag. During eltrombopag treatment, 38.9% showed hepatobiliary laboratory anomalies. Among 9 follow-up bone marrow examinations, 1 revealed fibrosis after 1 year of treatment. CONCLUSION: Eltrombopag was well tolerated with excellent treatment outcomes in refractory adult ITP patients. Low-dose eltrombopag effectively maintained the target platelet count. However, some patients required longer or higher-dose treatment to maintain the target platelet count, especially in heavily pretreated or longer ITP cases.
Adult* ; Bone Marrow Examination ; Fibrosis ; Follow-Up Studies ; Humans ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; Receptors, Thrombopoietin ; Thrombocytopenia*

PURPOSE: This study evaluated outcomes of radiotherapy (RT) after chemotherapy in limited-stage head-and-neck diffuse large B-cell lymphoma (DLBCL). MATERIALS AND METHODS: Eighty patients who were treated for limited-stage head-and-neck DLBCL with CHOP (n = 43) or R-CHOP (n = 37), were analyzed. After chemotherapy, RT was administered to the extended field (n = 60) or the involved field (n = 16), or the involved site (n = 4). The median dose of RT ranged from 36 Gy in case of those with a complete response, to 45–60 Gy in those with a partial response. RESULTS: In all patients, the 5-year overall survival (OS) and disease-free survival (DFS) rates were 83.9% and 80.1%, respectively. In comparison with the CHOP regimen, the R-CHOP regimen showed a better 5-year DFS (86.5% vs. 73.9%, p = 0.027) and a lower rate of treatment failures (25.6% vs. 8.1%, p = 0.040). The volume (p = 0.047) and dose of RT (p < 0.001) were significantly reduced in patients treated with R-CHOP compared to that in those treated with CHOP. CONCLUSION: The outcomes of RT after chemotherapy with R-CHOP were better than those of CHOP regimen for limited-stage head-and-neck DLBCL. In patients treated with R-CHOP, a reduced RT dose and volume might be feasible without increasing treatment failures.
Antineoplastic Agents ; B-Lymphocytes* ; Disease-Free Survival ; Drug Therapy ; Head and Neck Neoplasms ; Humans ; Lymphoma, B-Cell* ; Radiotherapy* ; Treatment Failure