A 48 years old male was visited with complaining of painful swelling of the left knee joint for 2 weeks duration. On radiological finding of the patella, there was found local rarefaction and osteolytic change in the inferior pole. It was diagnosed as Salmonella osteomyelitis of the patella and was confirmed by bacteriological study. Osteomyelitis of the patella caused by Salmonella group C as an etiological factor has not been reported. It was treated by conservative method with satisfactory result.
Humans ; Knee Joint ; Male ; Methods ; Osteomyelitis ; Patella ; Salmonella

No abstract available.
Child* ; Fever* ; Humans

No abstract available.
Humans

No abstract available.
Arginine ; Growth Hormone* ; Growth Hormone-Releasing Hormone ; Somatostatin

Polydactyly is one of the most common congenital anomalies of the limb, however its surgical treatment varies from simple excision to reconstruction. The purpose of this study is to present out classification of polydactyly in which the type of surgery was concerned primarily. Two hundred and thirty five digits(134 fingers and 101 toes) in 188 patients were operated from 1980 to 1992. We divided the polydactyly into two types-the simple type, in which the extradigit arises from only one digit, and the complex type in which the extradigit connects more than two adjacent main digits. The simple type was subdivided into joint type(type I), in that the extradigit has its own joint in its origine; epiphyseal type(type II), the extradigit share common epiphysis with main digit; and hypoplastic type(type III), the extradigit is connected only by soft tissue to the main digit. The epiphyseal type(type II) was further divided into subtype A(type IIA), in that the origin seems to be directly derived from the epiphysis; and subtype B(type IIB), which resemble an osteochondroma. Type III and type IIB can be treated by simple excision, however the type I and type IIB can be treated by arthroplasty with or without osteotomy as well as excision of extradigit. Result of surgical treatment in 1 digit of the simple form, which siginifies the extradigit arising from only one digit, are good in 193 digits(91%), fair 14(6.6%), and poor 5(2.4%) after an average follow-up period of 20 months. Our principles in the surgical treatment of polydactyly was treatment according to the type, and early treatment.
Arthroplasty ; Classification ; Epiphyses ; Extremities ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Osteochondroma ; Osteotomy ; Polydactyly

PURPOSE: The aim of the present study was to determine proper treatment strategies to improve the outcome of patients with gallbladder cancer by an analysis of multiple factors affecting tumor recurrence and patient survival. METHODS: Between January 1991 and April 2006, surgery with curative intent was performed on 120 patients with gallbladder cancer. Of 120 cases, 35 patients had findings that precluded any further intervention, and the remaining 85 patients underwent curative resections that included a simple cholecystectomy in 43 cases, a radical cholecystectomy in 32 cases and an extended cholecystectomy in 10 cases. Clinicopathogical data was analyzed. RESULTS: The presence of jaundice at presentation, gross morphology of the tumor, tumor cell differentiation, presence of a lymph node metastasis, lymphatic invasion and direct invasion to other contagious organ(s) and achievement of a tumor-free resection margin were associated with survival. For stage I gallbladder cancer, in only T2 lesions, patients that undergone a simple cholecystectomy had double the rate of recurrence as compared to patients that undergone a radical cholecystectomy (12.5% versus 26.1%; p = .119). For stage II gallbladder cancer, survival and disease-free survival for patients that undergone a radical cholecystectomy were improved as compared to patients that undergone a simple cholecystectomy; survival and disease-free survival was poor for patients that had undergone an extended cholecystectomy, especially in patients that had bile duct invasion (4/5; 80%). For stage III/IV gallbladder cancer, all patients (n = 6) underwent an extended cholecystectomy and half of the patients survived longer than one year. CONCLUSION: Radical cholecystectomy could be a standard procedure for gallbladder cancer in addition to just stage II cancer. An aggressive approach including resecting contagious organ(s) in locally advanced gallbladder cancer could provide a survival benefit without an increase in complications.
Achievement ; Bile Ducts ; Cell Differentiation ; Cholecystectomy ; Disease-Free Survival ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Jaundice ; Lymph Nodes ; Lymphatic Metastasis ; Recurrence

Skin lipids are a major constituent of the epidermal barrier, impermeable to a great extent to many chemicals. The barrier cspacity of the skin must be diminished by its delipidization through extract of the fatty material. The objectives of this study were to determine the degree that lipids and proteins contribute to the binding of straturn corneum in percutaneous penetration of hydrocortisone following skin delipidization. The binding capacity of C-hydrocortisone partitioned to powdered stratum corneum without delipidization in 10 human subjects was 1,554.34+/-357.48 dpm, and when delipidization, was 2,234.68+/-761.12 dpm. The partitioning rate was 0.38% in powdered stratum corneum without delipidization in 10 subjects, and when with ddipidization, was 0.55%. The result that the binding capacity of hydrocortisone to stratum corneum with delipidization increased more than without delipidization are statistically significant (p<0.05).
Humans* ; Hydrocortisone* ; Skin

BACKGROUND: Liver ischemia and reperfusion injury is associated with activation of several inflammatory pathways including cytokines, tumor necrosis factor (TNF) and cell-mediated tissue damage. tacrolimus causes a regulatory effect on some inflammatory pathways, such as cytokines, TNF, adhesion molecule and inflammatory cells. Prostaglandin E1 (PGE1) has shown vasodilatation by relaxing vascular smooth muscles and inhibits the effect of proinflammatory cytokines which could reduce leukocyte- sinusoidal and platelet-sinusoidal interactions. METHODS: Liver ischemia was induced in rats by occluding the vessels, the supplying median segment, and the left lateral segment with an aneurysmal clip for 60 minutes. The rats received tacrolimus (0.5 mg/kg, tacrolimus group) or PGE1 (100 ug/kg, PGE1 group) or normal saline (Control group) 30 and 5 minutes before ischemia and reperfusion of the liver, respectively. The serum ALT, nitric oxide, and TNF were determined at 1, 24, and 48 hours after reperfusion, and hepatic necrosis was determined at the same times by using HE staining and a microscopic grading system. RESULTS: 1) In the control group, the serum ALT and TNF levels had peak values at 1 hour and were gradually decreased, but the serum nitric-oxide level was gradually increased after the time of reperfusion (p<0.05). No necrosis existed at in one hour, but the tissue necrosis at 24 hours was higher than that at 48 hours (p<0.05). 2) At one hour, the tacrolimus group had significantly lower serum ALT and TNF levels and a higher serum nitric-oxide level in the liver compared with the control group, but the serum nitric-oxide level did not change significantly after reperfusion (p<0.05). The extent of hepatic necrosis was significantly inhibited in the tacrolimus group when compared with that in the control group and the PGE1 group (p<0.05). 3) The PGE1 group exhibited improved hepatic necrosis compared with the control group (p<0.05). The improved hepatic necrosis was reflected in reductions of the serum ALT and TNF and an increase in the serum nitric-oxide level. CONCLUSIONS: These result suggest that tacrolimus and PGE1 protect the liver against ischemia- reperfusion injury by reducing the serum TNF level and increasing the serum nitric-oxide level. The protective effect of tacrolimus is more beneficial than that of PGE1.
Alprostadil* ; Aneurysm ; Animals ; Cytokines ; Ischemia ; Liver* ; Muscle, Smooth, Vascular ; Necrosis ; Nitric Oxide ; Rats* ; Reperfusion ; Reperfusion Injury* ; Tacrolimus* ; Tumor Necrosis Factor-alpha ; Vasodilation

No abstract available.
Aging*

In a study by Mazzaferro et al, the patient with Milan criteria had excellent survival and disease free survival rate of 85 % and 92% respectively, at 4 years after liver transplantation and this criteria have been widely used as the guideline for the selection of candidates for liver transplantation in many transplantation center. Milan criteria will exclude a large portion of patients from liver transplantation and some studies suggested an expansion of the selection criteria without affecting outcome. The University of California, San Francisco (UCSF) group proposed an expansion of the selection criteria according to tumors characteristics, while preserving excellent survival after liver transplantation. The limitation of clinical staging system based soley on the results of the pretransplantation imaging technique, inaccurate and understaging identified as meeting standard criteria. when applied to pretransplantation evaluation, the expansion criteria are associated with lower survival rate and disease free survival rate. In contrast to long waiting time and high dropout rate in cadaver transplantation, living donor liver transplantation (LDLT) appear the alternative method and LDLT is chosen by the balance of the risk and benefit for donor and recipients. The most centers demonstrated favorable results in patients chosen by extended selection criteria. Most centers in Korea had a concensus on exclusion of extrahepatic metastasis and major vascular invasion in principle. The broadest criteria such as exclusion of major vessel invasion which expanded the patients by about 20%, result in the 3 years of 86.8%, not significant different from Milan criteria. With the aim of reducing dropout rates on the waiting list, locoregional therapy can be offered to patient at risk for tumor progression. While favorable results in terms of local tumor necrosis and improved survival rate were observed in some centers, others made poor efficacy. Whether liver transplantation or liver resection is the optional initial treatment for early tumor in compansated liver cirrhosis depends on the survival rate. The similar result in both treatment modality and the shortage of cadaver donor liver graft, Most center recommand the liver resection as the first line therapy. Resection first and salvage transplantation for recurrent tumor or liver failure has been shown to be a feasible strategy in the most patients.
Cadaver ; California ; Carcinoma, Hepatocellular* ; Disease-Free Survival ; Humans ; Korea ; Liver Cirrhosis ; Liver Failure ; Liver Transplantation* ; Liver* ; Living Donors ; Necrosis ; Neoplasm Metastasis ; Patient Dropouts ; Patient Selection ; Survival Rate ; Tissue Donors ; Transplants ; Waiting Lists