Functional-Below-Knee Total Contact Cast characterized by early weight bearing and free motion of affected knee joint during the cast immobilizaton has brought to significant result on trearment of tibial fractures, and is considered to take early bony union by establishment of almost physiological environment on fracture site during immobilization. For recent 2 years, writers have experienced many tibial fractures to treat with Functional Below-Knee Total Contact Cast. In them, clinical data and results of 17 cases which were studied well are reviewed, and method of cast application is illustrated.
Clinical Study ; Immobilization ; Knee Joint ; Methods ; Tibial Fractures ; Weight-Bearing

Avascular necrosis of the carpal lunate (Kienbock's Disease) was first described by Peste in 1843. It's etiology is still unknown. Since Lippman, in 1949, there have been many operative treatments for this disease but they had many complications and technical difficulties. The treatment of Kienbock's disease by resection of the lunate and replacement with fascia lata through the dorsal approach is very simple in operation method and its results were satisfactory in follow up study for postop 12, 18 months. We report two cases of Kienbock's disease with brief review of literature.
Fascia Lata ; Fascia ; Follow-Up Studies ; Methods ; Necrosis ; Osteonecrosis

Several growth factors and polypeptides are not commonly yet used for regenerators of bone tissue or alveolar bone because of the insufficiency of studies on their side effects, genetic engineering for mass production and stability for clinical application. Recently, many herbal medicines, which have advantage of less side effects and possibility of long-term use, have been studied for their capacity and effects of anti-bacterial, anti-inflammatory and regenerative potential of periodontal tissues. Morindae Radix, Cibotium Barometz (L.), Albizziae Cortex, Cistandhis Herba have been traditionally used as medicines for treatment of bone disease in Eastern medicine. The objective of the present study is to examine the ability of alkaline phosphatase (ALP) activity of human fetal osteoblast (hFOB1) when several natural medicines were supplemented. hFOB1 were cultured with Dulbecuo's Modified Eagle's Medium Nutrient Mixture F-12 HAM ( DMEM/F-12 1:1 Mixture, Sigma, USA) and negative control, dexamethasone (positive control), and each natural medicines for 3 days. And then ALP activity was measured by spectrophotometer for enzyme activity and Alizarin red S staining for morphometry. Among the natural medicines of this study, Morindae Radix, Cibotium Barometz (L.) and Cistanchis Herba induced higher activity of ALP synthesis than negative controls in all experimental group. Albizziae Cortex showed mild increases than negative control group. According to measurement of positively stained area, all of the natural medicines of this study increased compared to negative control. Especially, Cibotium Barometz (L.) and Cistanchis Herba showed statistical significance compared to negative control (p<0.05). These results indicate that Morindae Radix, Cibotium Barometz (L.), Albizziae Cortex, Cistandhis Herba have an inducing ability of ALP synthesis on osteoblast.
Albizzia ; Alkaline Phosphatase* ; Bone and Bones ; Bone Diseases ; Dexamethasone ; Genetic Engineering ; Humans* ; Intercellular Signaling Peptides and Proteins ; Morinda ; Osteoblasts* ; Peptides

The present study was to determine the influence of micro-macro biphasic calcium phosphate(MBCP) on proliferation and differentiation of human marrow-derived mesenchymal stem cells. Primary stem cells were cultured from bone marrow and 3-4 passaged cells were used. This study tested the proliferative effects by cell counting. Collagen sythensis, alkaline phosphatase activity, expression of osteocalcin and bone sialoprotein by Western blot analysis were evaluated. The cellular proliferation of ASC was not influenced by MBCP. Collagen synthesis of ASC cultured on MBCP significantly increased at 5th and 7th days(p<0.05). The ALP activity in ASC cultured on MBCP significantly increased at 5th and 7th days(p<0.05). The expression of OC and BSP incresaed in ASC cultured on MBCP. These results suggest that MBCP may stimulates the osteoblastic activity of ASC.
Adult Stem Cells* ; Adult* ; Alkaline Phosphatase ; Blotting, Western ; Bone Marrow ; Calcium* ; Cell Count ; Cell Proliferation ; Collagen ; Humans ; Integrin-Binding Sialoprotein ; Mesenchymal Stromal Cells ; Osteoblasts* ; Osteocalcin ; Stem Cells

BACKGROUND: Obesity is defined as an excess accumulation of body fat. To measure body fat accurately is difficult, but body mass index (BMI, kg/m2) is easily available for routine clinical use. METHODS: A total of 4,966 (male; 2,580, female; 2,386) patients from January to September in 1997 and aged up to 90 years old were studied for BMI. Among these subjects, obstetric patients were excluded in our study. We calculated the BMI as weight (kg) per height squared (m2). The heights and weights of study subjects were obtained from anesthesia records. The BMI was analyzed by 4 different age groups: group 1 (less than 3 years), group 2 (between 3 to 7 years), group 3 (between 8 to 17 years), and group 4 (18 years or more), decade of age, 4 obesity categories according to BMI levels: underweight (less than 18 kg/m2), normal weight (19-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (30 kg/m2 or more), and surgical departments. RESULTS: Mean BMI values of group 1, 2, 3, and 4 were 16.1+/-2.9 kg/m2, 16.2+/-2.4 kg/m2, 19.2+/-3.7 kg/m2 and 23.3+/-4.6 kg/m2 in males and 15.7+/-3.9 kg/m2, 15.8+/-2.7 kg/m2, 19.4+/-3.5 kg/m2 and 23.6+/-3.7 kg/m2 in females, respectively. According to generations, the BMI under teen-age was 16.3+/-2.7 kg/m2 and 14.3+/-2.9 kg/m2 in males and females respectively while it was between 20.4+/-3.3 kg/m2 to 25.0+/-3.6 kg/m2 from 1st to 7th decade patients in both sex. The prevalence of overweight and obesity were nearly zero in group 1 and 2, but males in group 3 had them of 4.6% and 1.4% while 6.9% and 0.8% in females, respectively. In group 4 they were 25.3% and 2.2% in males and 28.8% and 4.8% in females, respectively. Obese patients increased in the order of neurosurgery, gynecology, orthopedic surgery, urology, and general surgery departments. CONCLUSIONS: This study revealed the guidelines of BMI of operating patients. We recognized that the prevalence of overweight and obesity of preschool aged and adolescent patients were nearly zero. Adult patients were the highest at 4th decade in males and 6th decade in females and the obesity rates were 27.4% and 33.6% in males and females, respectively.
Adipose Tissue ; Adolescent ; Adult ; Aged, 80 and over ; Anesthesia ; Body Mass Index* ; Family Characteristics ; Female ; Gynecology ; Humans ; Male ; Neurosurgery ; Obesity ; Orthopedics ; Overweight ; Prevalence ; Thinness ; Urology ; Weights and Measures

Myasthenia gravis is relatively common in young women and therefore sometimes associated with pregnancy. Since pregnancy influences the course of the myasthenia gravis, and the drugs used for its treatment may influence gestation, the obstetrical management of myas-thenic patient merits special consideration. In myasthenia gravis, it is generally thought that the anesthesia of chice is regional anesthesia during vaginal delivery and general anesthesia during Cesarian section. But in Cesarina section for a pregnant myasthenic with pulmonary disease, epidural or subarachnoid block may be preferable to avoid postoperative hazards. We performed epidural anesthesia with lidocaine in a 39-year-old elderly primigravida myasthenic with COPD and obtained good intra and postoperative results.
Adult ; Aged ; Anesthesia ; Anesthesia, Conduction ; Anesthesia, Epidural ; Anesthesia, General ; Female ; Humans ; Lidocaine ; Lung Diseases ; Myasthenia Gravis ; Pregnancy ; Pulmonary Disease, Chronic Obstructive

Purpose: To develop a denoising convolutional neural network-based image processing technique and investigate its efficacy in diagnosing breast cancer using low-dose mammography imaging. Materials and Methods: A total of 6 breast radiologists were included in this prospective study. All radiologists independently evaluated low-dose images for lesion detection and rated them for diagnostic quality using a qualitative scale. After application of the denoising network, the same radiologists evaluated lesion detectability and image quality. For clinical application, a consensus on lesion type and localization on preoperative mammographic examinations of breast cancer patients was reached after discussion. Thereafter, coded low-dose, reconstructed full-dose, and full-dose images were presented and assessed in a random order. Results: Lesions on 40% reconstructed full-dose images were better perceived when compared with low-dose images of mastectomy specimens as a reference. In clinical application, as compared to 40% reconstructed images, higher values were given on full-dose images for resolution (p < 0.001); diagnostic quality for calcifications (p < 0.001); and for masses, asymmetry, or architectural distortion (p = 0.037). The 40% reconstructed images showed comparable values to 100% full-dose images for overall quality (p = 0.547), lesion visibility (p = 0.120), and contrast (p = 0.083), without significant differences. Conclusion Effective denoising and image reconstruction processing techniques can enable breast cancer diagnosis with substantial radiation dose reduction.

No abstract available.
Bone Regeneration ; Calcium* ; Heterografts ; Humans* ; Osteoblasts* ; Osteogenesis*

OBJECTIVES: To prevent progression to fatal asthma it is essential to assess the severity of asthma and treat adequetely. But there was no objective index to evaluate the severity of airway inflammation in asthmatic patients, So we evaluated that serum ECP concentration is a objective parameter of airway inflammation in patients with acute severe asthmatic attack. METHODS: We measured the parameters of asthamtic severtity(clinical parameter, FEV1, arterial blood gas, peripheral blood eosinophil counts, and serum ECP levels) before and after antiasthmatic treatment in 9patients with acute severe asthmatic attack, And we compared serum ECP concentrations of severe asthmatic patients with those of control patients with mild to moderate severity. RESULTS: 1) The serum ECP levels in patients with acute asthmatic attacks compared to patients with mild to moderate, asthmatic severity were significantly increased. 2) The serum ECP levels and pheriperal blood eosinophil counts 2hours after antiasthmatic treatment were significantly lower than the value before treatment, but the total scores of clinical parameter, FEV1, and scores of arterial blood gases were not significantly different from the basal values, CONCLUSION: It is suggested that the serum ECP level is a objective parameter as a response to antiasthmatic treatment as well as a severity of airway inflammation in patients with acute asthmatic attack.
Asthma ; Eosinophil Cationic Protein* ; Eosinophils ; Gases ; Humans ; Inflammation

Vibrio vulnificus, a halophilic vibrio is an estuarine gram-negative bacteria that is associated with severe and frequently fatal wound infections and life-threatening septicemia. Bacteriocins are defined as antibacterial substance produced by various species of bacteria which are usually active against closely related organisms. Bacteriocins have found widespread application in epidemiological studies as specific markers of bacteria. It was proposed by Ha et al. (1990. J. Korean. Soc. Microbiol. 25: 586.) to give the bacteriocins produced by V. vulnificus the name "vulnificins". In the present study, a total of 72 strains of V. vulnificus isolated from patients and oysters were subjected to screen potential producers and indicators of vulnificin, applying ultraviolet induction method. Sensitivity of several strains of Serratia marcesans, Pseudomonas aeruginosa, Shigella flexneri, Salmonella typhi and Yersinia enterocolitica to vulnificins were also examined out. All the tested strains of V. vulnificus produced vulnificins active against indicator strains with various different inhibitory patterns. The spectrum of vulnificin activity and sensitive spectrum of indicator strains were considerably broad. Interestingly, almost all strains of S. marcescens, P. aeruginosa, Salmonella sp., Shigella sp. and Y. enterocolitica tested were sensitive to 1-7 vulnificin(s). Taken together, the present study demonstrated that all of the isolates of V. vulnificus produced vulnificins and that 8 good vulnificin producers and 10 good indicators were detected. These strains can be employed efficiently for establishing vulnificin typing scheme of V. vulnificus and for the detection of bacteriocinogeny and sensitivity in V. vulnificus. Biological role of vulnificin remains to be further elucidated.
Bacteria ; Bacteriocins ; Gram-Negative Bacteria ; Humans ; Ostreidae ; Pseudomonas aeruginosa ; Salmonella ; Salmonella typhi ; Sepsis ; Serratia ; Shigella ; Shigella flexneri ; Vibrio vulnificus* ; Vibrio* ; Wound Infection ; Yersinia enterocolitica