It is well estabilshed that the xerosis is closely related to diabeic pruritus. Although the causes of xerosis are thought to bie the abnormalities of sweating and autonomic nervous system, the exact mechanism of the xerosis in diabetic skin is still unknown. This study was designed to investigate the possible derangement of glucose metabolism in the skin of diabetes mellitus patients with xerosis. The epidemal glucose content and hexokonase activities were masured in the skin samples obtained from normal individuals and diabetes mellitus patients with xerosis The epidermal glucose content was measured by the enzymatic cycling method. The enzymatic activities of hexokinase were assayed by fluorometric method. The epidermal glucose content of diabetic patients increaed approximately twice [27.46+9.52 (mmole/kg /dry weight) that of normal individuals [13.90+4.79(mmole/kg /dry weight)] (p<0. 0001). The epidermal hexokinase activities of diabetes patients were significantly decreased [0.56+0.15(mole/hr/kg/dry weight)] compared to that of normal indivduals [0.96+0.24(mole/hr/kg dry weight)] (p<0.0001). There were no significant differences in the epidermal glucose content and enzyme activities of hexokinase between the diabetic patients with: erosis and diabetic patients without xerosis. These data indicated that decreased activities of hexokinase could reduce the glucose phopkiorylation and uptake into keratinocytes, and which could lead to accumulat. glucose in the interstitial space of diabetic epidermis. And the decreased hexokinase activities may exert on lipid metabolism and glycolysis of diabetic epiidermis, because hexokinase is a key enzyme of hexose monophosphate pathway and glycolysis.
Autonomic Nervous System ; Diabetes Mellitus ; Epidermis ; Glucose ; Glycolysis ; Hexokinase* ; Humans ; Keratinocytes ; Lipid Metabolism ; Metabolism ; Pruritus ; Skin ; Sweat ; Sweating

BACKGROUND: This study was performed to evaluate the results of intervention activities on the management of steam sterilizers and sterile items in out-patient clinics and clinical laboratories. METHODS: A checklist was developed and used to monitor and evaluate the adequacy of sterilizers and sterilized items at out-patient clinics and clinical laboratories in a tertiary-care hospital. The checklist consisted of 7 items: condition of the material used for packaging sterile items, maintenance of shelf-life records, sterilizer cleanliness, maintenance of expiry date details of sterilized items, sterilization conditions, use of chemical indicators, and the results of biological indicators. Monitoring and additional intervention activities were carried out once every week for 53 weeks from August 2007 to July 2008. The study period was divided into 2 terms, early and late intervention; the duration of each term was 6 months, and we compared the ratio of adequacy of management of sterilizer and sterilized items between the 2 terms. RESULTS: There were a total of 795 observations from 15 departments in 1 year. Sterility of the materials used for packaging increased from 87.4% in the first 6-month term to 97.9% in the second 6-month term. Records for shelf-life increased from 89.6% to 98.5% in the same period, while the figures for maintaining expiry date details of sterilized items and for steam sterilizer cleanliness increased from 92.6% to 99.2%, and from 91.9% to 98.5 (P<0.05), respectively. CONCLUSION: Our intensive checklist-based intervention was effective in improving the management of steam sterilizers and sterile items in out-patient clinics and clinical laboratories.
Ambulatory Care Facilities ; Checklist ; Humans ; Infertility ; Organothiophosphorus Compounds ; Outpatients ; Product Packaging ; Steam ; Sterilization

For the morphological analysis of DMBA (9,10-diemethyl-1,2-benzanthracene) induced tumor, thirty Sprague-Dawley rats were received 0.1 ml of a 2% paraffin solution of DMBA into the knee joint cavity, which was repeated three times at an interval of 4 weeks. The induced tumor masses were removed at the 12th week after the first injection. Histological and histochemical examinations (H & E, PAS, alcian blue, Van Gieson, prussian blue, reticulin, PTAH stain) and enzyme histochemical examinations (acid phosphatase, alkaline phosphatase, alpha-naphthyl acetate esterase) were performed. The results were as follows: 1) By the 12th week after the first injection of DMBA, the tumor incidence rate was 20 percent. 2) On histological and histochemical examination, most of the induced tumor disclosed the features of the fibrous histiocytoma originating from mesenchymal cells, and the remains sweat gland adenoma and adenocarcinoma originating from epithelial cells. 3) On enzyme histochemical examination, most of the mesenchymal cell-derived tumor cells showed positive reactions for acid phosphatase and alpha-naphthyl acetate esterase, which were similar characteristic features of enzyme stains as shown in the component cells of fibrous histiocytoma.
Rats ; Animals ; Incidence ; Adenocarcinoma ; Adenoma

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: To report a case of isolated posterior pole-penetrating ocular injury treated by nonsurgical methods such as argon laser photocoagulation and administration of antibiotics. CASE SUMMARY: A 46-year-old male visited the hospital complaining of floaters in his left eye which had occurred when his cheek was penetrated by scissors from the inferior posterior part to the superior anterior part while working earlier that day. Upon initial examination, his best corrected visual acuity (BCVA) in the left eye was 0.8, and his intraocular pressure (IOP) was 10 mmHg. No cells or aqueous flares were observed in the anterior chamber. Fundus examination was performed, and three disc diameter-large breaks of the retina and choroid, scleral rupture and vitreous hemorrhage were observed at the posterior pole three disc diameters away from the fovea. It was difficult to make a surgical approach as the lesion was situated on the posterior pole, and there was the risk of prolapse of the eye contents. Therefore, we first performed argon laser photocoagulation around the lesion and administered topical as well as and systemic antibiotics. After admission the patient was observed carefully as the tractional retinal fold was located at the posterior pole. Additional argon laser photocoagulation was performed. After six months of treatment, BCVA in the left eye was 1.0, IOP was 16 mmHg, and no pathologic change was observed on fundus examination.
Anterior Chamber ; Anti-Bacterial Agents ; Aqueous Humor ; Argon ; Cheek ; Choroid ; Eye ; Humans ; Intraocular Pressure ; Light Coagulation ; Male ; Middle Aged ; Prolapse ; Retina ; Retinaldehyde ; Rupture ; Traction ; Visual Acuity ; Vitreous Hemorrhage

BACKGROUND AND OBJECTIVES: Recurrent vestibulopathy is defined a disease characterized by more than a single episode of vertigo of duration characteristic of endolymphatic hydrops but without auditory or clinical neurological symptoms or signs. To investigate the clinical characteristics and the efficacy of combination therapy, we analyzed the clinical records of the patients diagnosed as recurrent vestibulopathy. MATERIALS AND METHOD: Clinical records of sixty four patients diagnosed as recurrent vestibulopathy were retrospectively reviewed. The data on age, sex distribution, natural history, family history of recurrent vestibulopathy, concurrent headache, caloric response was analyzed. The efficacy of combination therapy for vertigo control in the patients with a minimum 24-month follow-up was also evaluated. RESULTS: Mean onset age of recurrent vestibulopathy was 43 years and there was a female preponderance. Concurrent headache and elevated SP/AP ratio in electrocochleogram was frequently observed in these patients. After the combination medical therapy, patients with severe recurrent vestibulopathy showed significant decrease in the number of vertigo spells with 37.5% of complete control of vertigo. CONCLUSION: As a distinctive clinical disorder with unknown cause, recurrent vestibulopathy should be always considered to the patients complaining recurrent episodic vertigo. Combination therapy individualized to the symptoms and signs of the patients with recurrent vestibulopathy might be effective in reducing the frequency of vertigo attacks. Further case-control studies with large population should be necessary.
Age of Onset ; Case-Control Studies ; Endolymphatic Hydrops ; Female ; Follow-Up Studies ; Headache ; Humans ; Natural History ; Retrospective Studies ; Sex Distribution ; Vertigo ; Vestibular Neuronitis*

PURPOSE: To report a case of conjunctival autotransplantation using the conjunctival flap of the pterygium for thetreatment corneal ulcer perforation. CASE SUMMARY: A 72-year-old woman was referred to our hospital because her left eye had a corneal ulcer due topine needle trauma, and she did not respond to the initial therapy in a private clinic for 1 week. We first applied topical and systemic antibiotics. However, the lesion did not subside, and necrosis progressed in the stroma at the center of the cornea. On day 6 of admission, perforation was found at the center of the cornea, and we excised the necrotic tissue and performed bilateral pedicle conjunctival flap transposition. After the operation, an ischemic change was observed, and in the fourth week perforation occured at the center of the transplanted conjunctival flap. Because we considered it difficult to perform the transplantation of a conjunctival flap in the left eye, we performed autotransplantation on the corneal perforation in the left eye using conjunctival flap obtained through a pterygium excision in the right eye. After the operation, vascular ingrowth started from the edge of the flap, and there were no symptoms of inflammation, shrinkage, or necrosis of the flap. During the follow-up observation, the flap survived well without necrosis.
Aged ; Anti-Bacterial Agents ; Cornea ; Corneal Perforation ; Corneal Ulcer ; Eye ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Necrosis ; Needles ; Pterygium ; Transplants

PURPOSE: To report a case of conjunctival autotransplantation using the conjunctival flap of the pterygium for thetreatment corneal ulcer perforation. CASE SUMMARY: A 72-year-old woman was referred to our hospital because her left eye had a corneal ulcer due topine needle trauma, and she did not respond to the initial therapy in a private clinic for 1 week. We first applied topical and systemic antibiotics. However, the lesion did not subside, and necrosis progressed in the stroma at the center of the cornea. On day 6 of admission, perforation was found at the center of the cornea, and we excised the necrotic tissue and performed bilateral pedicle conjunctival flap transposition. After the operation, an ischemic change was observed, and in the fourth week perforation occured at the center of the transplanted conjunctival flap. Because we considered it difficult to perform the transplantation of a conjunctival flap in the left eye, we performed autotransplantation on the corneal perforation in the left eye using conjunctival flap obtained through a pterygium excision in the right eye. After the operation, vascular ingrowth started from the edge of the flap, and there were no symptoms of inflammation, shrinkage, or necrosis of the flap. During the follow-up observation, the flap survived well without necrosis.
Aged ; Anti-Bacterial Agents ; Cornea ; Corneal Perforation ; Corneal Ulcer ; Eye ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Necrosis ; Needles ; Pterygium ; Transplants

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

BACKGROUND AND OBJECTIVES: Although disequilibrium is common type of dizziness in older people, it is sometimes difficult to identify a specific cause for this problem. The diffuse brain pathology including subcortical ischemia and atrophy can be a cause for patients with disequilibrium of unknown cause. Aim of this study is to identify the eye movements and neuroimaging features in patients with disequilibrium. MATERIALS AND METHODS: We performed a prospective investigation in patients with disequilibrium of unknown cause. We collected information on demographic characteristics and clinical features of disequilibrium. The impact of dizziness on everyday life was assessed by 25-item dizziness handicap inventory (DHI). Vestibular function test (VFT) includes smooth pursuit, saccade, optokinetic nystagmus, and rotatory chair test. Subcortical white matter lesions and brain atrophy were graded from brain magnetic resonance image (MRI). RESULTS: This study included 14 patients (12 female and 2 male), aged between 64 and 84 years, mean age 74.01+/-6.02 years. The score of DHI was 39.4+/-11.8 (20-58). Eye movements were abnormal in 13 patients and normal in only one patient. The degree of subcortical ischemia was mild in 7, moderate in 4, and severe in 3 patients. Ventricular brain ratio was 0.23+/-0.03. However, there was no significant relationship between MRI findings and the degree of oculomotor alterations (result of VFT). CONCLUSION: Patients with disequilibrium of unknown cause are usually elderly women. Alterations in oculomotor movements and diffuse brain pathology including white matter lesions and atrophy were observed in patients with disequilibrium of unknown cause.
Aged ; Atrophy ; Brain ; Brain Diseases ; Brain Ischemia ; Dizziness ; Eye Movements ; Female ; Humans ; Ischemia ; Magnetic Resonance Imaging ; Neuroimaging ; Nystagmus, Optokinetic ; Prospective Studies ; Pursuit, Smooth ; Saccades ; Vestibular Function Tests