OBJECTIVE: To investigate the effect of laterally wedged insole on static balance of patients with degenerative osteoarthritic knees. METHOD: Eighteen female patients were diagnosed with medial compartment knee degenerative osteoarthritis (OA) based on symptoms and simple X-rays. Patients were studied while they stood wearing shoes with the 5 degrees or 10 degrees lateral wedged insoles compared with a bare foot. Patients chose a comfortable stance with feet spread apart, slightly turned outwards, and were asked to look straight ahead at a fixed point in a quiet room. Postural sway and weight load asymmetry were recorded while the patients were standing on two adjacent force platforms during a 30 second trial. RESULTS: Postural sway and weight load asymmetry for 30 seconds were not significantly changed by wearing laterally wedged insoles with varying elevations (p>0.05). CONCLUSION: The degree of the postural sway and weight load asymmetry for 30 seconds with the insole were not affected by the tilt of the lateral wedge.
Female ; Foot ; Humans ; Knee* ; Osteoarthritis* ; Osteoarthritis, Knee ; Shoes

A 59 year-old female patient suffered from complex regional pain syndrome in left hemiplegia, was managed to stellate ganglion block (SGB) with 5 ml of 1 % lidocaine. The SGB was performed twice previously, with no side effects. And the third SGB was done in the same manner after negative aspiration testing. Two minutes later, she developed respiratory difficulty with increased blood pressure. Immediately airway management was performed by mask ventilation with oxygen. But ten minutes later, she developed respiratory arrest with unconsciousness and intubation was performed. Soon she recovered spontaneous respiration and the blood pressure returned to the former level. Despite taking all precautions during SGB, complications such as respiratory arrest and hypertension may occur even in the hands of an experienced physician. Therefore, before starting SGB, all resuscitation drugs and equipment must be ready for use in case any emergency develops.
Airway Management ; Blood Pressure* ; Emergencies ; Female ; Hand ; Hemiplegia ; Humans ; Hypertension ; Intubation ; Lidocaine ; Masks ; Middle Aged ; Oxygen ; Respiration ; Resuscitation ; Stellate Ganglion* ; Unconsciousness* ; Ventilation

We experienced a rare case of traumatic displacement of the globe into the ethmoid sinus. A 66-year-old man sustained trauma of the right eye and orbit, which resulted in displacement of the globe into the ethmoid sinus. One day after injury, surgery was performed to restore the intact globe into position within the orbit. Ten days after the operation, light perception was noticed only when transillumination was placed into orbit. Trace test undergone 45 days after the operation, no sight were measured from right eye, and the movement of right eyeball was not possible in any direction. We believe that the nerve and extraocular muscles were severed against the floor of the orbit or severely traumatized as the globe entered the ethmoid sinus. This case is very rare and never reported in Korea. We treated by replacing the globe in the orbit surgically and reconstructing the orbital floor with acurate diagnosis by the Computed Tomography(CT) scan.
Aged ; Diagnosis ; Ethmoid Sinus* ; Humans ; Korea ; Muscles ; Orbit ; Transillumination

STUDY DESIGN: Retrospective study. PURPOSE: To more accurately determine the incidence and clarify risk factors. OVERVIEW OF LITERATURE: Superior mesenteric artery syndrome is one of the possible complications following correctional operation for scoliosis. However, when preliminary symptoms are vague, the diagnosis of superior mesenteric artery syndrome may be easily missed. METHODS: We conducted a retrospective study using clinical data from 118 patients (43 men and 75 women) who underwent correctional operations for scoliosis between September 2001 and August 2007. The mean patient age was 15.9 years (range 9~24 years). The risk factors under scrutiny were the patient body mass index (BMI), change in Cobb's angle, and trunk length. RESULTS: The incidence of subjects confirmed to have obstruction was 2.5%. However, the rate increased to 7.6% with the inclusion of the 6 subjects who only showed clinical symptoms of obstruction without confirmative study. The BMI for the asymptomatic and symptomatic groups were 18.4+/-3.4 and 14.6+/-3, respectively. The change in Cobb's angle for the asymptomatic and symptomatic groups were 24.8+/-13.6degrees and 23.4+/-9.1degrees, respectively. The change in trunk length for the asymptomatic and symptomatic groups were 2.3+/-2.1 cm and 4.5+/-4.8 cm, respectively. Differences in Cobb's angle and the change in trunk length between the two groups did not reach statistical significance, although there was a greater increase in trunk length for the symptomatic group than for the asymptomatic group. CONCLUSIONS: Our study shows that the incidence of superior mesenteric artery syndrome may be greater than the previously accepted rate of 4.7%. Therefore, in the face of any early signs or symptoms of superior mesenteric artery syndrome, prompt recognition and treatment are necessary.
Body Mass Index ; Humans ; Incidence ; Male ; Mesenteric Artery, Superior ; Retrospective Studies ; Risk Factors ; Scoliosis ; Superior Mesenteric Artery Syndrome

An adrenocortical carcinoma is a rare malignancy, which is associated with a poor prognosis. Eighty percent of adrenal tumors are functional, and commonly secrete glucocorticoids alone (45%), glucocorticoids and androgens (45%) or androgen alone (10%). Less than 1% of all cases secrete aldosterone. A case of a 75 year old female patient was experienced, presenting with anadrenocortical carcinoma and associated concurrent Cushing's syndrome and primary aldosteronism. She had complained of left flank pain for 5 months, and also showed clinical features of Cushing's syndrome, hypertension, hypokalemia and a left abdominal mass. An abdominal CT* demonstrated a large left adrenal mass, with necrosis, and a hemorrhage in the left upper abdomen. The plasma renin activity was 0.51 ng/ml/hr, and the serum aldosterone level was increased by 46.4 ng/dL. A low and high dose dexamethasone suppression test revealed no suppression. Histologically, the tumor was diagnosed as a adrenocortical carcinoma. After complete removal of the mass, she received mitotan and prednisolone as adjuvant therapies. Liver and bone metastasis occurred after 6 months of treatment, so was treated with palliative radiotherapy for the bone metastasis
Abdomen ; Adrenocortical Carcinoma* ; Aged ; Aldosterone ; Androgens ; Cushing Syndrome* ; Dexamethasone ; Female ; Flank Pain ; Glucocorticoids ; Hemorrhage ; Humans ; Hyperaldosteronism* ; Hypertension ; Hypokalemia ; Liver ; Necrosis ; Neoplasm Metastasis ; Plasma ; Prednisolone ; Prognosis ; Radiotherapy ; Renin

An adrenocortical carcinoma is a rare malignancy, which is associated with a poor prognosis. Eighty percent of adrenal tumors are functional, and commonly secrete glucocorticoids alone (45%), glucocorticoids and androgens (45%) or androgen alone (10%). Less than 1% of all cases secrete aldosterone. A case of a 75 year old female patient was experienced, presenting with anadrenocortical carcinoma and associated concurrent Cushing's syndrome and primary aldosteronism. She had complained of left flank pain for 5 months, and also showed clinical features of Cushing's syndrome, hypertension, hypokalemia and a left abdominal mass. An abdominal CT* demonstrated a large left adrenal mass, with necrosis, and a hemorrhage in the left upper abdomen. The plasma renin activity was 0.51 ng/ml/hr, and the serum aldosterone level was increased by 46.4 ng/dL. A low and high dose dexamethasone suppression test revealed no suppression. Histologically, the tumor was diagnosed as a adrenocortical carcinoma. After complete removal of the mass, she received mitotan and prednisolone as adjuvant therapies. Liver and bone metastasis occurred after 6 months of treatment, so was treated with palliative radiotherapy for the bone metastasis
Abdomen ; Adrenocortical Carcinoma* ; Aged ; Aldosterone ; Androgens ; Cushing Syndrome* ; Dexamethasone ; Female ; Flank Pain ; Glucocorticoids ; Hemorrhage ; Humans ; Hyperaldosteronism* ; Hypertension ; Hypokalemia ; Liver ; Necrosis ; Neoplasm Metastasis ; Plasma ; Prednisolone ; Prognosis ; Radiotherapy ; Renin

Human embryonic stem (hES) cells are capable of differentiating into pluralistic cell types, however, spontaneous differentiation generally gives rise to a limited number of specific differentiated cell types and a large degree of cell heterogeneity. In an effort to increase the efficiency of specified hES cell differentiation, we performed a series of transient transfection of hES cells with EGFP expression vectors driven by different promoter systems, including human cellular polypeptide chain elongation factor 1 alpha (hEF1alpha), human cytomegalo-virus, and chicken beta-actin. All these promoters were found to lead reporter gene expression in undifferentiated hES cells, but very few drug-selectable transfectants were obtained and failed to maintain stable expression of the transgene with either chemical or electroporation methods. In an attempt to increase transfection efficiency and obtain stable transgene expression, differentiated hES cells expressing both mesodermal and ectodermal markers were derived using a defined medium. Differentiated hES cells were electroporated with a hEF1alpha promoter-driven EGFP or human noggin expression vector. Using RT-PCR, immunocytochemistry and fluorescence microscopy, the differentiated hES cells transfected with foreign genes were confirmed to retain stable gene and protein expression during prolonged culture. These results may provide a new tool for introducing exogenous genes readily into hES cells, thereby facilitating more directed differentiation into specific and homogenous cell populations.
Actins/genetics ; Animals ; Bone Morphogenetic Proteins/genetics ; *Cell Differentiation ; Chickens ; Cytomegalovirus/genetics ; Drug Delivery Systems ; Embryo/*cytology ; *Gene Therapy ; Green Fluorescent Proteins/genetics/*metabolism ; Humans ; Immunoenzyme Techniques ; Microscopy, Fluorescence ; Peptide Elongation Factor 1/genetics ; Pluripotent Stem Cells/*cytology ; Promoter Regions (Genetics)/*genetics ; Research Support, Non-U.S. Gov't ; Reverse Transcriptase Polymerase Chain Reaction ; Transcription, Genetic/genetics