BACKGROUND: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. METHODS: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. RESULTS: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. CONCLUSIONS: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.
Acromion ; California ; Clavicle* ; Humans ; Osteolysis ; Periprosthetic Fractures ; Shoulder ; Skin

BACKGROUND: The early diagnosis of invasive candidiasis is the most important for reducing of morbidity and mortality rates in the immunocompromised patients. The study of antigen detection was performed by Cand-Tec kit, but antibody detection by Western blot, had not been reported. OBJECTIVE: We reviewed 62 cases of suspected invasive candidiasis(10), immunocompromised patients with leukemia, leukopenia, pneumonia, et al(44) and normal colonization control(8) in the urine and sputum for the immunological diagnosis of invasive candidiasis by Cand-Tec and Western blot assays. METHODS: The antigen and antibody detection were done by both Cand-Tec kit and Western blot assay, in the sera of the patients collected from several hospitals. RESULTS: The sera from 4(40%) and 8(80%) of 10 suspected invasive candidiasis had a threshold positive titers of > or = 1:4 by latex agglutination (Cand-Tec) and the results of positive antibody to the immunodominant antigen (47KDa) of Candida spp. by Western blot assay, each other. Both antigen and antibody we.e detected from 21(47%) of 44 patients in the immunocompromised group and 1(12%) of 8 cases with normal flora, separately, but the antibodies from 3(18%) of 16 healthy controls were detected by Western blot analysis, only. CONCLUSION: This study confirm that the Western blot method of detecting antibody against immunodominant antigen(47KDa) of Candida spp. was more effective than antigen detection by Cand-Tec method for immunodiagnosis of invasive candidiasis.
Agglutination ; Antibodies ; Blotting, Western ; Candida ; Candidiasis, Invasive* ; Colon ; Diagnosis* ; Early Diagnosis ; Humans ; Immunocompromised Host ; Immunologic Tests ; Latex ; Leukemia ; Leukopenia ; Mortality ; Pneumonia ; Sputum

Kallmann's syndrome is characterized by hypogonadotrophic hypogonadism resulting from insufficient release of GnRH and associated with anosmia or hyposmia, which has been related to agenesis of olfactory bulbs. We experienced a case of 17 year-old Kallmann's syndrome woman and a case of successful pregnancy of 29 year-old Kallmann's syndrome woman with hMG and hCG treatment and present two cases with a review of literatures.
Adolescent ; Adult ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Hypogonadism ; Kallmann Syndrome* ; Olfaction Disorders ; Olfactory Bulb ; Pregnancy*

Basilar migraine is a rare type of migraine with complex symptoms including aura such as dysarthria, vertigo, tinnitus, and decreased level of consciousness. A 13-year-old male patient was presented with severe headache and immobility of whole body for 20 minutes after vomiting, dizziness, and dysarthria. Similar episode of headache and unconsciousness after vomiting happened 2 weeks ago prior to the visit. Vital signs were stable and pupils showed positive light reflex. Brain MRI and MRA, EEG, and electrocardiography revealed no abnormality. One day after discharge from hospital, patient revisited emergency room because of similar episode of headache. Preventive medication was started with flunarizine 5 mg per day. However, similar episodes of headache and loss of consciousness repeated three times over the next four months. Topiramate was then added with dose of 100 mg divided into two doses. Since then, the patient has been symptom free over 1 year.
Adolescent ; Brain ; Consciousness ; Dizziness ; Dysarthria ; Electrocardiography ; Electroencephalography ; Emergencies ; Epilepsy ; Flunarizine ; Fructose ; Headache ; Humans ; Light ; Male ; Migraine Disorders ; Migraine with Aura ; Paralysis ; Pupil ; Reflex ; Tinnitus ; Unconsciousness ; Vertigo ; Vital Signs ; Vomiting

BACKGROUND: Intrathecal (IT) neostigmine produces analgesia in animal and human. This study was designed to evaluate the efficacy and safety of IT neostigmine for post-cesarean section analgesia. METHODS: Forty-five women undergoing cesarean section under spinal anesthesia were randomly assigned into 3 groups to receive; normal saline 0.2 ml, or neostigmine 12.5 microgram, or neostigmine 25 microgram intrathecally with 0.5% hyperbaric bupivacaine 12 mg. Degrees of sensory and motor blocks, maternal hemodynamic changes, and side effects were recorded. Apgar scores and umbilical vein blood gas analysis (UVBGA) were checked for evaluation of fetal status. Postoperative analgesia was provided by intravenous patient-controlled analgesia (PCA) using fentanyl 500 microgram and ketorolac 150 mg in 100 ml. Pain scores with 10-cm visual analogue scale (VAS), time to first PCA use, cumulative PCA consumptions, and side effects were assessed at 1, 2, 4, 8, 12, 24, and 48 hr after IT injection. RESULTS: There were no significant differences among the three groups in characteristics of spinal anesthesia, maternal blood pressure and heart rate, Apgar scores, and UVBGA data. Compared to saline group, IT neostigmine significantly prolonged time to first PCA use and decreased 24 hr- and 48 hr-PCA consumptions (P<0.05). Pain scores in neostigmine groups were significantly lower than those in saline group for first 4 hr after which there were no differences among the three groups. There were significantly higher incidences of nausea and vomiting in neostigmine groups than in saline group. CONCLUSIONS: These data indicate that IT neostigmine can be an alternative postoperative analgesic without adverse fetal effects for cesarean section. However, high incidence of nausea and vomiting seem to limit its clinical usefulness. Further studies are necessary to enhance its analgesic effects and to decrease its adverse effects.
Analgesia* ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Animals ; Blood Gas Analysis ; Blood Pressure ; Bupivacaine ; Cesarean Section ; Female ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Ketorolac ; Nausea ; Neostigmine* ; Passive Cutaneous Anaphylaxis ; Pregnancy ; Umbilical Veins ; Vomiting

OBJECTIVE: To investigate the cross-sectional association of the obesity with the knee osteoarthritis (OA) in a rural population. METHOD: We studied the cross-sectional asssociation between the obesity and the knee OA by analysis of data (Juam-Study based data) from an epidemiologic survey of a population of 1,100 adults who resided around the Juam lake in Chonnam. The recruited sampling were 475 adults above 40 years old. We diagnosed knee OA by typical clinical features such as bony swelling, crepitus and pain on movement and divided the subjects into non-OA group (143 males:148 females) and OA group (60 males:124 females). There is no difference in the mean ages of two groups. The body mass index (BMI) was calculated from a weight and height (kg/m2) and body fat percent (BFP) was measured by bioelectric impedance fatness analyzer (BIA). We defined obesity as a BMI over 30 kg/m2 in both sex or a BFP over 25% in male and over 30% in female. The BMI and BFP were 23.2 +/- 3.2 kg/m2, 24.0 +/- 7.5% in non-OA group and 23.5 +/- 3.4 kg/m2, 26.0 +/- 7.0% in OA group and were compared in two groups. RESULTS: 1) Prevalence odds ratio (POR) for risk factors of knee OA was high in seventh decade, female, a high cholesterol group, and a high BFP group, and was not high in BMI group. 2) There was no association between BMI and knee OA. 3) There was no association between BFP and knee OA. CONCLUSION: We were not able to prove the cross-sectional association between obesity and knee OA. The results suggested that knee OA was a heterogeneous disorder and more possibly influenced by multiple other factors, such as age, sex, and various metabolic abnormalities than obesity itself.
Adipose Tissue ; Adult ; Body Mass Index ; Cholesterol ; Electric Impedance ; Female ; Humans ; Jeollanam-do ; Knee* ; Lakes ; Male ; Obesity* ; Odds Ratio ; Osteoarthritis, Knee* ; Prevalence ; Risk Factors ; Rural Population*

Non-alcoholic fatty liver disease (NAFLD) has the potential to develop into hepatic steatosis and progress to terminal liver diseases such as cirrhosis and hepatocellular carcinoma. This human clinical study was aimed to demonstrate that SPB-201 (powdered-water extract of Artemisia annua) can improve liver function in subjects with non-alcoholic liver dysfunction at mild to moderate levels. A decrease of 271% in aspartate aminotransferase (AST) level and a significant decrease of 334% in alanine aminotransferase (ALT) level was observed in the test group as compared to the control group at the 4 weeks follow-up. In addition, after 8 weeks, decreases of 199% in AST level and 216% in ALT level were reported in the test group as compared to the control group. These results confirmed that SPB-201 intake significantly enhanced liver function and health. Moreover, the Multidimensional Fatigue Scale score of the test group decreased but that of the control group increased, implicating that SPB-201 also eliminated overall fatigue. No significant adverse events were observed among all subjects during the study. Taken together, our clinical study confirmed the excellent efficacy and safety of SPB-201 in liver function improvement, showing the possibility of SPB-201 as a functional food to restore liver dysfunction and treat liver diseases.

Non-alcoholic fatty liver disease (NAFLD) has the potential to develop into hepatic steatosis and progress to terminal liver diseases such as cirrhosis and hepatocellular carcinoma. This human clinical study was aimed to demonstrate that SPB-201 (powdered-water extract of Artemisia annua) can improve liver function in subjects with non-alcoholic liver dysfunction at mild to moderate levels. A decrease of 271% in aspartate aminotransferase (AST) level and a significant decrease of 334% in alanine aminotransferase (ALT) level was observed in the test group as compared to the control group at the 4 weeks follow-up. In addition, after 8 weeks, decreases of 199% in AST level and 216% in ALT level were reported in the test group as compared to the control group. These results confirmed that SPB-201 intake significantly enhanced liver function and health. Moreover, the Multidimensional Fatigue Scale score of the test group decreased but that of the control group increased, implicating that SPB-201 also eliminated overall fatigue. No significant adverse events were observed among all subjects during the study. Taken together, our clinical study confirmed the excellent efficacy and safety of SPB-201 in liver function improvement, showing the possibility of SPB-201 as a functional food to restore liver dysfunction and treat liver diseases.

BACKGROUND: The membrane permeability transition of mitochondria has been suggested to be involved in toxic and oxidative forms of cell injury. Mitochondrial dysfunction is considered to play a critical role in neurodegeneration in Parkinson's disease. Despite the suggestion that indole beta-carbolines may be neurotoxic, these compounds provide a protective effect against cytotoxicity of other neurotoxins. In addition, the effect of indole beta-carbolines on change in the mitochondrial membrane permeability due to reactive nitrogen species (RNS), which may lead to cell death, has not been clarified. METHODS: Differentiated PC12 cells were used as the experimental culture model for the investigation of neuronal cell injury, which occurs in Parkinson's disease. The effect of indole beta-carbolines (harmalol and harmine) on differentiated PC12 cells against toxicity of S-nitroso-N-acetyl-DL-penicillamine (SNAP) was determined by measuring the effect on the change in transmembrane potential, cytochrome c release, formation of ROS, GSH contents, caspase-3 activity and cell viability, and was compared to that of R-(-)-deprenyl. RESULTS: Specific inhibitors of caspases (z-LEHD.fmk, z-DQMD.fmk) and antioxidants (N-acetylcysteine, dithiothreitol, melatonin, carboxy-PTIO and uric acid) depressed cell death in PC12 cells due to SNAP. beta-Carbolines and R-(-)-deprenyl attenuated the SNAP-induced cell death and GSH depletion concentration dependently with a maximal inhibitory effect at 25-50 microM. The compounds inhibited the nuclear damage, decrease in mitochondrial transmembrane potential, cytochrome c release and formation of reactive oxygen species caused by SNAP in PC12 cells. beta-Carbolines and R-(-)-deprenyl attenuated the H2O2-induced cell death and depletion of GSH. CONCLUSIONS: The results suggest that indole beta-carbolines attenuate the SNAP-induced viability loss in PC12 cells by inhibition of change in the mitochondrial membrane permeability, which may be caused by free radicals. Indole beta-carbolines appear to exert a protective effect against the nitrogen species-mediated neuronal cell injury in Parkinson's disease comparable to R-(-)-deprenyl.
Animals ; Antioxidants ; Carbolines* ; Caspase 3 ; Caspases ; Cell Death* ; Cell Survival ; Cytochromes c ; Dithiothreitol ; Free Radicals ; Melatonin ; Membrane Potentials ; Membranes ; Mitochondria ; Mitochondrial Membranes ; Neurons ; Neurotoxins ; Nitrogen* ; Parkinson Disease* ; PC12 Cells ; Permeability ; Reactive Nitrogen Species ; Reactive Oxygen Species

Hypersensitivity to mosquito bites (HMB) is a rare disease characterized by intense skin reactions such as bulla and necrotic ulcerations at bite sites, accompanied by general symptoms such as high-grade fever and malaise occurred after mosquito bites. It has been suggested that HMB is associated with chronic Epstein-Barr virus (EBV) infection and natural killer (NK) cell leukemia/lymphoma. We describe here a Korean child who presented with 3-yr history of HMB without natural killer cell lymphocytosis. He has been ill for 6 yr with HMB. Close observation and examination for the development of lymphoproliferative status or hematologic malignant disorders is needed.
Child ; Epstein-Barr Virus Infections/complications ; Humans ; Hypersensitivity/*diagnosis/etiology ; Insect Bites and Stings/*diagnosis/pathology ; Killer Cells, Natural/immunology ; Lymphocytosis/complications/pathology ; Male ; Republic of Korea ; Skin/pathology