PURPOSE: To find out the advantages and disadvantages of the suture technique and improve the method of operation. MATERIALS AND METHODS: Postoperative follow-up of at least one year was possible in thirteen cases including 7 surgical neck fractures and 6 three-part fractures. The results were analysed radiographically and clinically using a modified UCLA scale. RESULTS: There was one non-union and except for that case, the average union time was 10.2 weeks. Active forward flexion averaged 140 degrees, external rotation 50 degrees and internal rotation between T12 and L1 vertebra. The clinical results were 3 excellent, 5 good and 4 fair. There was no significant corelation (P=0.538) between fracture type and clinical results statistically. But for above 65 years, the UCLA scale averaged 25.8 points and for under 65 years, 31.6 points (P=0.006 ) . CONCLUSION: The use of a suture technique for these displaced fracture without the use of metals achieved a high percentage of acceptable results. But in order to achieve good stability and early exercise, the neck fragment had to be impacted into the humeral head and the medial and lateral part of the neck fracture should be fixed together. Therefore, it is difficult to use this method for severely comminuted neck fractures.
Follow-Up Studies ; Humeral Head ; Metals ; Neck ; Shoulder Fractures* ; Spine ; Suture Techniques* ; Sutures*

PURPOSE: The authors investigated the process of endochondral ossification quantitatively and objectively in respect to proliferation and apoptosis. MATERIALS AND METHODS: Fractures were made on the left tibiae of 72 male Sprague-Dawley rats. The fracture callus was harvested at the 5th, 7th, 9th, 11th, 14th, and the 21st day after fracture. Cellular DNA content was analyzed with image cytometry, and proliferative index was determined from the data. The Ki-67 antigen expression was semiquantitatively measured by the immunohisto-chemical method. TUNEL was used for in situ localization of apoptotic cells. The expression of cell cycle inhibitors, P21 and P27, was investigated with Northern blotting. RESULTS: The proliferation index was highest on the 5th day, then gradually decreased until the 11th day. The expression of Ki-67 antigen gradually decreased with time. Apoptotic cells increased in accordance with enhanced bone formation within chondroid callus. The expression of p21 and p27 was highest on the 11th and the 14th day. CONCLUSIONS: These findings show that proliferative activity decreased with the reduction of mesenchymal tissue and the appearance of mature chondroid tissue. The apoptosis of hypertrophic chondrocytes occurred in accordance with enhanced bone formation. P21 and P27 had a certain role in the differentiation of chondrocytes.
Apoptosis* ; Blotting, Northern ; Bony Callus ; Cell Cycle ; Cell Proliferation* ; Chondrocytes ; DNA ; Fracture Healing* ; Humans ; Image Cytometry ; In Situ Nick-End Labeling ; Ki-67 Antigen ; Male ; Osteogenesis ; Rats, Sprague-Dawley ; Tibia

Apoptosis signal-regulating kinase 1 (ASK1) is an upstream signaling molecule in oxidative stress-induced responses. Because oxidative stress is involved in asthma pathogenesis, ASK1 gene deficiency was investigated in animal models of allergic asthma.However, there is no study to investigate whether ASK1 inhibitors could be applied for asthma to date. Selonsertib, a potent and selective ASK1 inhibitor, was applied to BALB/c mice of an ovalbumin (OVA)-induced allergic asthma model. Selonsertib suppressed antigen-induced degranulation of RBL-2H3 mast cells in a concentration-dependent manner. The administration of selonsertib both before OVA sensitization and OVA challenge significantly reduced airway hyperresponsiveness, and suppressed eosinophil numbers and inflammatory cytokine levels in the bronchoalveolar lavage fluid. Histopathologic examination elucidated less inflammatory responses and reduced mucin-producing cells around the peribronchial regions of the lungs. Selonsertib also suppressed the IgE levels in serum and the protein levels of IL-13 in the bronchoalveolar lavage fluid. These results suggest that selonsertib may ameliorate allergic asthma by suppressing immune responses and be applicable to allergic asthma.

PURPOSE: We evaluated the efficiency of low contact stress(LCS) system in total knee arthroplasty by analyzing clinical and radiological results. MATERIALS AND METHODS: Out of 128 cases who underwent total knee arthroplasty with meniscal bearing type LCS system, eighty one cases who were followed up for more than two years were analysed. Average follow-up period was 32,6 months(24 months-48 months). The diagnoses were six cases of degenerative arthritis, eighteen cases of rheumatoid arthritis, and two cases of avascular necrosis. Clinical analysis were performed by American Knee Society Knee Score and Hospital for Special Surgery(HSS) knee score and radiographic analysis were performed by the Knee Society Roentgenographic Evaluation and Scoring System. RESULTS: Average preoperative flexion contracture was improved from 13.4 degrees preoperatively to 1.2 degrees at final follow-up and average arc of motion was changed from 107 degrees preopeatively to 108 degrees at final follow-up without significant improvement. American Knee Society Knee Score was improved from average 55.2 preoperatively to 88.5 at final follow-up. HSS knee score also showed improvement from average 58.2 to 86.5. Tibio-femoral angle was improved from 6.3 degrees of varus preoperatively to 5.1 degrees of valgus at final follow-up. Radiolucent lines was seen most commonly at zone 1 in anteroposterior radiograph of tibia and in zone 1 in lateral radiograph of femur. Complications such as superficial wound infection, stiffness, and meniscal bearing fracture were seen in four cases. CONCLUSION: Total knee arthroplasty using LCS system showed satisfactory improvement in flexion contracture, deformity correction. Clinical and radiographic result.
Arthritis, Rheumatoid ; Arthroplasty* ; Congenital Abnormalities ; Contracture ; Diagnosis ; Femur ; Follow-Up Studies ; Knee* ; Necrosis ; Osteoarthritis ; Tibia ; Wound Infection

OBJECTIVE: To present the profiles of spinal cord tumors that can be removed through a unilateral hemilaminectomy and to demonstrate its usefulness for benign spinal cord tumors that significantly occupy the spinal canal. METHODS: From June 2004 to October 2010, 25 spinal cord tumors were approached with unilateral hemilaminectomy. We calculated the cross-sectional occupying ratio (CSOR) of tumor to spinal canal before and after the operations. RESULTS: The locations of the tumors were intradural extramedullary in 20 cases, extradural in 2, and intramedullary in 3. The levels of the tumors were lumbar in 12, thoracic 9, and cervical 4. In all cases, the tumor was removed grossly and totally without damaging spinal cord or roots. The mean height and width of the lesions we195re 17.64 mm (3-47.5) and 12.62 mm (4-32.7), respectively. The mean CSOR was 69.40% (range, 27.8-96.9%). Postoperative neurological status showed improvement in all patients except one whose neurologic deficit remained unchanged. Postoperative spinal stability was preserved during the follow-up period (mean, 21.5 months) in all cases. Tumor recurrence did not develop during the follow-up period. CONCLUSION: Unilateral hemilaminectomy combined with microsurgical technique provides sufficient space for the removal of diverse spinal cord tumors. The basic profiles of the spinal cord tumors which can be removed through the unilateral hemilaminectomy demonstrate its role for the surgery of the benign spinal cord tumors in various sizes.
Follow-Up Studies ; Humans ; Laminectomy ; Microsurgery ; Neurologic Manifestations ; Recurrence ; Spinal Canal ; Spinal Cord ; Spinal Cord Neoplasms*

OBJECTIVE: The intracranial pathologies after head trauma should be usually progressed. It is clearly visualized in the non-invasive brain CT. The invasive monitor such as intracranial pressure (ICP) monitoring may be accompanied with the complications. This study aims whether the patients with severe head injury could be managed with serial CT scans. METHODS: The medical records of 113 patients with severe head injury in the prospectively enrolled trauma bank were retrospectively analyzed. After the emergency care, all the patients were admitted to the intensive care unit for the aggressive medical managements. Repeat brain CT scans were routinely taken at 6 hours and 48 hours after the trauma. ICP monitoring was restrictively applied for the uncertain intracranial pressure based on the CT. The surgical intervention and the mortality rate were analyzed. RESULTS: Immediate surgical intervention after the initial CT scan was done in 47 patients. Among the initially non-surgical patients, 59 patients were managed with the serial CT scans and 7 with the ICP monitoring. Surgical interventions underwent eventually for 10 patients in the initially non-surgical patients; 1 in the ICP monitoring and 9 in the serial CT. The mortality rate was 23.7% in the serial brain CT and 28.6% in the ICP monitoring. There was no statistical difference between two groups in the aspect of mortality (p=0.33). CONCLUSION: Serial CT scans in time could be a good way to monitor the intracranial progression in the severe head injury and reduce the implantation of an invasive ICP probe.
Brain* ; Craniocerebral Trauma* ; Emergency Medical Services ; Humans ; Intensive Care Units ; Intracranial Pressure* ; Medical Records ; Mortality ; Pathology ; Prospective Studies ; Retrospective Studies ; Tomography, X-Ray Computed*

Injuries from sea urchins are induced by from penetration of the calcareous spines into the skin. Apart from the transient episode of excruciating pain, there is usually no residual disability. Complications arise, however, when spines are embedded over bony prominences, or within joints. Two cases are reported with injury and protracted disability of fingers resulting from contact with the purple sea urchin, Anthocidaris crassispina, a common echinoderm inhabitant of the Korean east coast. After a latent period of several months in both cases, Case 1 presented as caseating granulomas in the synovium and case 2 exhibited as the usual soft tissue nonsynovial foreign body and noncaseating granulomas. There appears to be a paucity of published data regarding the effects of puncture wounds caused by the spines of this animal. The granulomas have appeared after a latent interval of several months in a proportion of the sufferers, suggests a delayed hyperserisitivity reaction similar to that produced by Mycobacterium species.
Animals ; Anthocidaris ; Bites and Stings* ; Fingers ; Foreign Bodies ; Granuloma ; Hand* ; Hypersensitivity, Delayed ; Inflammation* ; Joints ; Mycobacterium ; Punctures ; Sea Urchins* ; Skin ; Spine ; Strongylocentrotus purpuratus ; Synovial Membrane ; Wounds and Injuries

Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are well recognized syndromes related to the rapid correction of hyponatremia. Cognitive dysfunction and neuropsychological findings, however, have seldom been reported. We present a case of EPM without CPM and report the neuropsychological findings. Neuropsychological testing showed severe impairment of attention, verbal and visual memory, visuospatial functioning, and frontal/executive functioning. Language and language-related functions were normal except for naming. Follow-up neuropsychological testing at 4 months later showed slightly less impairment than the first assessment.
Follow-Up Studies* ; Hyponatremia ; Memory ; Myelinolysis, Central Pontine* ; Neuropsychological Tests

No abstract available.
Aneurysm* ; Subarachnoid Hemorrhage*

A 7 year-old girl presented with generalized muscle weakness and delayed motor development. She was able to stand up at 15 months and began to walk at 4 years of age. A nerve conduction study showed severe demyelinating neuropa-thy .There was no family history of peripheral neuropathy, and her parents and younger brother were clinically and electrophysiologically normal. A sural nerve biopsy showed moderate loss of myelinated fibers with onion-bulb forma-tions. Many teased nerve fibers revealed typical tomaculous changes. However the molecular genetic study of the patient confirms the duplication of 17p11.2-p22 on a polymerase chain reaction using D17S261 as a primer but not in her parents.
Biopsy ; Charcot-Marie-Tooth Disease ; Child ; Female ; Genotype ; Humans ; Molecular Biology ; Muscle Weakness ; Myelin Sheath ; Nerve Fibers ; Neural Conduction ; Parents ; Peripheral Nervous System Diseases ; Phenotype ; Polymerase Chain Reaction ; Siblings ; Sural Nerve