We performed a retrospective analysis of the results of surgical treatment of sixteen patient with comminuted fracture of the distal femur from September 1993 to August 1995 and evaluated the efficacy of the angled blade plate as one of the fixation devices used. The fractures were limited to C2 and C3 fracture classifed according to the AO classification. After an average follow-up of 13 months (range, 9 to 24 months), all of the fractures had healed. Postoperatively, the arc of flexion was limited between 90degrees and 125degrees in eight, normal arc in five, and severely restricted arc of joint motion was present unexceptionally in three patients with deep infection. In angular deformity, average 5.8degrees of valgus and 2.4degrees posterior angulation were showed. The functional results by Sanders-Swiontkowski-Rosen-Helfet rating system were showed excellent in 3, good in 7, fair in 3, and poor in 3 cases. The overall results were seen to be excellent to good in ten cases (62.5%) but in twelve patients using the angled blade plate, excellent to good results were showed 10 patients (83.3%). We attribute the favorable results in our series to restoration of the articular surface through the modified extensile approach, sufficient stable fixation using the angled blade plate with conforming to the concept of bridge plate, routinely performing the bone graft for medial buttress and bone healing, and early mobilization of the extremity.
Classification ; Congenital Abnormalities ; Early Ambulation ; Extremities ; Femur* ; Follow-Up Studies ; Fractures, Comminuted ; Humans ; Joints ; Retrospective Studies ; Transplants

Determination of the immunoglobulin M(IgM) in umbilical cord sera has been advocated as a screening test for intrauterine infection, since the IgM is produced by the fetus and is not transported across the placenta from mother. The low level of IgM in normal neonate is thought to reflect the infrequent encounter of antigenic stimuli by the futus, upon exposure to an appropriate antigen, however, the fetus is capable of increased IgM production, as has been doucumented in infant with rubella syndrome, cytomegalic inclusion disease, toxoplasmosis and syphilis. But until now we don't have the normal value of cord serum IgM in Korean neonate yet. So we performed the study to determine the normal value of serum IgM in Korean neonate and further more we try to compare the value of other condition such as congenital syphilis, maternal infection during pregnancy other than syphilis and congenital anomalies. Results were as followes: 1. Normal value of cord Igm was 11.83+/-9.92 mg % 2. There was no sexual difference 3. Lowest levele were noted at small weight(2500 gm upwards arrow) and short gestation period(28 wk upwards arrow) but not significant thereafter 4. There was no difference by matenal age and socioeconomic status 5. In congenital syphilis there was significant increment of cord IgM compared with normal group 6. There was no significant increment of cord ISM in cogenital anomalies 7. After 6 months, IgM levels were increased to adult level.
Adult ; Cytomegalovirus Infections ; Fetal Blood ; Fetus ; Humans ; Immunoglobulin M* ; Immunoglobulins* ; Infant ; Infant, Newborn ; Mass Screening ; Mothers ; Placenta ; Pregnancy ; Reference Values ; Rubella ; Social Class ; Syphilis ; Syphilis, Congenital ; Toxoplasmosis ; Umbilical Cord

Estrogen receptors (ERs) are members of nuclear receptors and related to several diseases such as cancer, inflammation and osteoporosis. ERs have two forms, ERα and ERβ, which have different functions and organism distributions. Compounds selectively targeting ERβ can regulate important physiological functions and avoid the side effects caused by targeting ERα. Therefore, selective ERβ ligands have received considerable research interest in recent years. In this article, different kinds of selective ERβ ligands were summarized and their structure-activity relationships were also analyzed.
Estrogen Receptor beta ; chemistry ; Humans ; Ligands ; Structure-Activity Relationship

OBJECTIVETo investigate the feasibility and clinical application value of selecting viable spermatozoa by noncontact diode laser.

METHODSWe obtained immotile spermatozoa from 2 infertile men with obstructive azoospermia or severe asthenospermia and selected viable spermatozoa using a single laser shot at the sperm tail. Those that responded to the laser shot by a curling reaction of the tail were regarded as presumably viable and used for intracytoplasmic sperm injection (ICSI).

RESULTSThe mean fertilization rate was 88.89% after ICSI with the laser-selected viable spermatozoa. Both of the embryo transfers resulted in a single pregnancy.

CONCLUSIONNoncontact diode laser is a useful alternative for the assessment of sperm viability, which may help to achieve successful pregnancy.

Embryo Transfer ; Female ; Fertilization ; Humans ; Infertility, Male ; therapy ; Male ; Pregnancy ; Pregnancy Outcome ; Sperm Injections, Intracytoplasmic ; Sperm Motility ; Sperm Tail ; physiology

PURPOSE: Lumbar puncture is an essential and commonly practiced diagnostic tool and post-lumbar puncture headache and post-lumbar puncture back pain are common neurological complications. The aim of this study is to identify the factors that might cause post-lumbar puncture back pain and to reduce those complaints by eliminating the causes. METHODS: From June 5, 2013 to July 29, 2013, we studied 155 patients, male and female between the age 1 and 18,who received diagnostic or therapeutic lumbar puncture at Pusan National University Hospital and Pusan National University Yangsan Hospital. We collected data of variable aspects that may influence post-lumbar puncture back pain, by reviewing the medical records retrospectively. The independent variables were sex, age, symptoms, diagnosis, number of trials to successful lumbar puncture, year of the resident who carried out the procedure, opening pressure of cerebrospinal fluid(CSF), spinal level of punctured site, duration of strict bed rest, and use of sedatives for the procedure. RESULTS: Among the 155 patients whounderwent lumbar puncture, 36 (23.2%) experienced back pain after the procedure. Back pain subsided within 48hours in 24 ofthe 36 patients. Only one patient suffered from post-lumbar puncture back pain for more than 5days. There is no clear causality between the occurrence rate of post-lumbar puncture back pain and the independent variables which includeage, sex, duration of bed rest, symptoms, diagnosis, number of trials, skill, opening pressure, anatomic location, and use of sedatives. CONCLUSION: Back pain was a frequent complication of lumbar puncture. Various factors we expected to influence on the incidence of post-lumbar puncture back pain had no statistical significance. Further studies should be performed to investigate the causes and risk factors of post-lumbar puncture back pain.
Back Pain* ; Bed Rest ; Busan ; Child* ; Diagnosis ; Female ; Gyeongsangnam-do ; Humans ; Hypnotics and Sedatives ; Incidence ; Male ; Medical Records ; Post-Dural Puncture Headache ; Punctures* ; Retrospective Studies ; Risk Factors ; Spinal Puncture

OBJECTIVEFor anti-inflammation, relieving pain and decreasing acute toxicity, the best condition for extracting procedure of Psammosilene tunicoides was chosen. And the relationships between several solvent extracts and pharmacodynamic index were studied.

METHODUniform design with multi-targets was used in the optimization process, and the evaluate index were the results of anti-inflammation, relieving pain and LD50 were employed as the evaluating indexes. At the same time, the contents of the extracts, water extract, acetic ester extract and ether extract were determined.

RESULTThe best condition is that the medicinal material is optimized with 8 times of water (pH 6-7) and 2 h of each time. The best condition is satisfactory by test verification. And the pharmacodynamic actions of anti-inflammation, relieving pain and LD, were not obviously related to the dry extracts, water extract, acetic ester extract and ether extract.

CONCLUSIONUniform design method with pharmacodynamic index has the merit of being relaated to the function and symptom directly. The extracted twice technology condition optimized is stable, feasible and suitable for industry production. And it is not suitable to take the solvent extracts as quality control index related to the function and symptom.

Animals ; Caryophyllaceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Female ; Inflammation ; drug therapy ; Lethal Dose 50 ; Male ; Mice ; Pain ; drug therapy ; Random Allocation

PURPOSE: To compare clinical outcomes after management with bed rest versus cerclage for treatment of amniotic sac bulging in the second trimester. METHODS: Women with cervical incompetence with membranes at or beyond a dilated external cervical os, before 27weeks of gestation, were treated with bed rest or emergency cerclage. We analyzed the pregnancy outcome retrospectively. 25 women underwent an emergency cerclege and 35 women underwent the bed rest. RESULTS: Gestational age at time of diagnosis was 22.40 weeks in the emergency cerclage and 22.39 weeks in the bed rest group. Mean interval from diagnosis until delivery was 8.65 weeks in the emergency cerclage group and 1.18 weeks in the bed rest group (p<0.001). Mean gestational age at delivery was 31 weeks in emergency cerclage group and 23.74 weeks in the bed rest group (p<0.001). Preterm delivery before 26 weeks and 34 weeks of gestation were significantly lower in the emergency cerclage group (p<0.001). Perinatal mortality was 17.4% in the emergency cerclage group and 48.6% in bed rest group (P=0.026). CONCLUSION: Emergency cerclage reduced preterm delivery before 26 and 34 weeks and improved perinatal outcome compared with bed rest treatment.
Bed Rest ; Emergencies ; Extraembryonic Membranes ; Female ; Gestational Age ; Humans ; Membranes ; Perinatal Mortality ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Retrospective Studies

PURPOSE: To determine the means, medians and reference intervals for TSH (thyroid-stimulating hormone) and fT4 (free thyroxine) for each month of gestation and for three trimesters in Korean pregnant women. METHODS: Serum samples were collected from 265 pregnant women with singleton gestation. Levels of TSH, fT4 were measured by immunoassay. After exclusion of subjects with positive antimicrosomal autoantibodies, the means, medians and reference intervals based on 2.5th and 97.5th percentiles for TSH, fT4 were determined. RESULTS: The study population consisted of 94 women in first trimester, 49 women in second trimester, and 122 women in third trimester. The trimester-specific reference intervals were: TSH (1st trimester: 0.03~2.72, 2nd: 0.27~2.29, and 3rd: 0.03~2.88 mIU/L), fT4 (1st trimester 4.50~19.75, 2nd: 4.70~12.98 and 3rd: 5.07~11.84 pg/mL). fT4 levels were significantly lower in the second and third trimesters. TSH levels were lower in the first trimester than second and third trimester, with gradual elevation in the second and third trimester. CONCLUSION: Levels of TSH, fT4 during pregnancy differ from those in non-pregnant women. Gestational age specific reference intervals will play a cental role in screening and diagnosis of thyroid disorders. Further studies for normal reference ranges during pregnancy are needed to create reference intervals in Korean pregnant women.
Autoantibodies ; Female ; Gestational Age ; Humans ; Immunoassay ; Mass Screening ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnant Women ; Reference Values ; Thyroid Function Tests ; Thyroid Gland ; Thyrotropin

OBJECTIVETo evaluate the prevalence of FLT3 gene expression and internal tandem duplication (ITD) mutation in acute myeloid leukemia (AML) patients and its clinical significance.

METHODSThe expression level of FLT3 mRNA was detected with real-time quantitative RT-PCR (RQ-PCR) technique in 152 bone marrow samples from 129 AML patients. The ITD of the FLT3 gene (FLT3/ITD) was detected in 75 de novo AML patients by reverse transcription polymerase chain reaction (RT-PCR).

RESULTSThe expression levels of FLT3 mRNA was 0.0020(0.0006 - 0.0040) in normal controls, and 0.1041 (0 - 33.8736) in 80 de novo AML patients (P = 0.001). FLT3/ITDs were found in 11 (14.7%) of 75 de novo AML patients. The FLT3 expression levels in patients with FLT3/ITD were 0.0297 to 33.8736 with a median level of 0.2200, and in those without FLT3/ITD were 0 to 26.2200 with a median level of 0.0975. The FLT3 expression levels in the former patients were higher than that in the latter ones, but there was no statistical significance (P = 0.093). The complete remission (CR) rate was lower in acute promyelocytic leukemia (APL) patients with FLT3/ITD than in APL patients without FLT3/ITD (P = 0.015). In de novo AML other than APL patients without FLT3/ITD, the CR rate was lower in patients with higher levels of FLT3 expression (expression level > 0.04, CR rate 37.5%) than those with lower levels of FLT3 expression (expression level < 0.04, CR rate 100%). On follow-up of 20 patients, the FLT3 expression level was decreased at least one logarithm degree when they got CR, but it was no significant change in non-remission patients.

CONCLUSIONSQuantification of FLT3 mRNA expression level and detection of FLT3/ITD in AML patients may serve as an index for evaluating therapeutic efficacy, predicting prognosis, and monitoring minimal residual disease.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Mutation ; Prognosis ; RNA, Messenger ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Tandem Repeat Sequences ; Treatment Outcome ; Young Adult ; fms-Like Tyrosine Kinase 3 ; genetics

OBJECTIVETo investigate the gene mutations of ADAMTS13 in a highly suspected hereditary thrombocytopenic purpura (TTP) patient, and then make a progressive diagnosis and adjust the plan of therapy.

METHODSADAMTS13 activity and inhibitor were determined by residual-collagen binding assay during several episodes. Genomic DNA extracted from the proband's peripheral blood was used for amplification of 29 exons and exon/intron boundaries of ADAMTS13 by PCR. The PCR products were screened by direct sequencing and the gene alterations were further confirmed by direct sequencing in her family members.

RESULTThe activity of the proband's ADAMTS13 was significantly reduced while no inhibitor was found. Two novel missense mutations were found in the TSPI repeated motif domain of ADAMTS13. In both mutations, thymine substituted for cytidine, resulting in the substitution of leucine for serine in nt 2708, exon 21 (codon S903L), and tryptophan for arginine in nt 3283, exon 25(codon R1095W). These two mutations were revealed as each heterozygote in the proband's parents.

CONCLUSIONThe deficiency of ADAMTS13 caused by two homozygote missense mutations might be responsible for episode of this TTP patient.

ADAM Proteins ; genetics ; Adult ; Exons ; genetics ; Female ; Humans ; Mutation ; Purpura, Thrombotic Thrombocytopenic ; genetics