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*

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

PURPOSE: Osteolysis has become a major cause of aseptic loosening in total hip arthroplasty. Macrophages phagocytose wear debris from implants and release the pro-inflammatory mediators such as IL-1beta, IL-6, TNF-alpha and nitric oxide. We evaluated the effects of metal patricles on the release of bone-associated cytokines and nitric oxide from J774 mouse macrophage cell line. MATERIALS AND METHODS: Titanium-Aluminum-Vanadium (Ti6Al4V) and Cobalt-Chrome-Aluminium (CoCr) particles were loaded and nitric oxide production was measured indirectly by the nitrite assay. The effect on cell proliferation, and apoptosis were also investigated with non-isotopic proliferation assay, and ELISA to DNA and histone. The levels of two proinflammatory cytokines, IL-6 and TNF-alpha, were measured with ELISA. The modulatory effect of anti-inflammatory cytokine on the nitrite, IL-6 and TNF-alpha production was additionally investigated. RESULTS: Nitrite levels increased after administration of Ti6Al4V and CoCr particle. IL-10 and IL-4 inhibited the production of nitrite with TiAl4V particle, but not in significant amount with CoCr particles. Cellular proliferative activity decreased and apoptosis increased after administration of Ti6Al4V and CoCr particle. Levels of IL-6 and TNF-a increased with both particles. IL-10 and IL-4 inhibited the production of IL-6 and TNF-alpha in varying degrees. CONCLUSION: Our data confirmed the increased production of pro-inflammatory cytokines and nitric oxide with metal particles and the inhibitory effect of IL-10 and IL-4 on the production of these substances, and suggest differences in the specific action between different metal particles.
Animals ; Apoptosis ; Arthroplasty, Replacement, Hip ; Cell Line ; Cell Proliferation ; Cytokines* ; DNA ; Enzyme-Linked Immunosorbent Assay ; Histones ; Interleukin-10 ; Interleukin-4 ; Interleukin-6 ; Macrophages ; Mice ; Nitric Oxide ; Osteolysis* ; Tumor Necrosis Factor-alpha

PURPOSE: Osteolysis has become a major cause of aseptic loosening in total hip arthroplasty. Macrophages phagocytose wear debris from implants and release the pro-inflammatory mediators such as IL-1beta, IL-6, TNF-alpha and nitric oxide. We evaluated the effects of metal patricles on the release of bone-associated cytokines and nitric oxide from J774 mouse macrophage cell line. MATERIALS AND METHODS: Titanium-Aluminum-Vanadium (Ti6Al4V) and Cobalt-Chrome-Aluminium (CoCr) particles were loaded and nitric oxide production was measured indirectly by the nitrite assay. The effect on cell proliferation, and apoptosis were also investigated with non-isotopic proliferation assay, and ELISA to DNA and histone. The levels of two proinflammatory cytokines, IL-6 and TNF-alpha, were measured with ELISA. The modulatory effect of anti-inflammatory cytokine on the nitrite, IL-6 and TNF-alpha production was additionally investigated. RESULTS: Nitrite levels increased after administration of Ti6Al4V and CoCr particle. IL-10 and IL-4 inhibited the production of nitrite with TiAl4V particle, but not in significant amount with CoCr particles. Cellular proliferative activity decreased and apoptosis increased after administration of Ti6Al4V and CoCr particle. Levels of IL-6 and TNF-a increased with both particles. IL-10 and IL-4 inhibited the production of IL-6 and TNF-alpha in varying degrees. CONCLUSION: Our data confirmed the increased production of pro-inflammatory cytokines and nitric oxide with metal particles and the inhibitory effect of IL-10 and IL-4 on the production of these substances, and suggest differences in the specific action between different metal particles.
Animals ; Apoptosis ; Arthroplasty, Replacement, Hip ; Cell Line ; Cell Proliferation ; Cytokines* ; DNA ; Enzyme-Linked Immunosorbent Assay ; Histones ; Interleukin-10 ; Interleukin-4 ; Interleukin-6 ; Macrophages ; Mice ; Nitric Oxide ; Osteolysis* ; Tumor Necrosis Factor-alpha

Premature menopause can be developed as a result of undesired nontarget ovary embolization during the performance of uterine fibroid embolization. The etiology of ovarian failure after uterine fibroid embolization is not yet clearly defined, but one of the leading possibilities is nontarget embolization of the ovaries. We report here on two cases in which superselective coil embolization of distal uterine artery collateral pathways to the ovary was performed during uterine fibroid embolization.
Angiography ; Embolization, Therapeutic* ; Female ; Leiomyoma* ; Menopause, Premature ; Ovary ; Uterine Artery ; Uterus

Premature menopause can be developed as a result of undesired nontarget ovary embolization during the performance of uterine fibroid embolization. The etiology of ovarian failure after uterine fibroid embolization is not yet clearly defined, but one of the leading possibilities is nontarget embolization of the ovaries. We report here on two cases in which superselective coil embolization of distal uterine artery collateral pathways to the ovary was performed during uterine fibroid embolization.
Angiography ; Embolization, Therapeutic* ; Female ; Leiomyoma* ; Menopause, Premature ; Ovary ; Uterine Artery ; Uterus