BACKGROUND: Sun exposure and therapeutic irradiation have been shown to induce alterations in extracellular matrix (ECM) proteins, including elastin, glycosaminoglycan and collagens. The integrity of the connective tissue mainly depends on balanced rates of matrix synthesis and degradation of the extracellular matrix. Therefore, matrix metalloproteinases (MMPs) may be involved in ultraviolet irradiation (UVR)-induced alterations in ECM proteins. OBJECTIVE: To evaluate the effects of UVA as well as UVB irradiations on ST-1 gene expression in cultured human skin fibroblasts. METHODS: After exposure of different doses of UVA and UVB on cultured human skin fibroblasts, we examined the expression of ST-1 gene by Northern blot analysis, chloramphenicol acetyltransferase (CAT) assay with CAT construct containing AP-1 binding site. Additionally, we carried out the gel mobility shift assay to investigate the effects of UVR on the DNA-binding activity of AP-1. RESULTS: After UVR on fibroblasts, the steady-state levels of ST-1 mRNA were in-creased in response to UVA and UVB by 2.5-fold and 4.2-fold, respectively, as compared with controls. Similar results were obtained by CAT assay showing that CAT activity increased as the UVA and UVB doses increased. Furthermore, gel mobility shift assay demonstrated that both UVA and UVB increased AP-1 DNA binding complexes. CONCLUSION: UVB as well as UVA up-regulated ST-1 gene expression at transcriptional levels in vitro. We speculate that modulation of MMPs, including ST-1, gene expression by UVR may contribute to the connective tissue damage related to photoaging and other photocutaneous disorders.
Animals ; Binding Sites ; Blotting, Northern ; Cats ; Chloramphenicol O-Acetyltransferase ; Collagen ; Connective Tissue ; DNA ; Elastin ; Electrophoretic Mobility Shift Assay ; Extracellular Matrix ; Fibroblasts* ; Gene Expression ; Humans* ; In Vitro Techniques ; Matrix Metalloproteinases ; RNA, Messenger ; Skin ; Solar System ; Transcription Factor AP-1

Enlargement of bone tunnels has been noted on plain X-rays following arthroscopic ACL reconstruction. The cause of this widening is unclear, but it has been hypothesized that it may be due to either mechanical or biological cases. Ishibashi et al. reported anatomical proximal fixation resulted in the most stable reconstructed knee, with increasing instability as the level of fixation moved away from the tibial plateau. The purpose of this study is to determine if any difference exists in the amount of enlargement of the femoral tunnel following arhotoscopic ACL reconstruction with position of interference screw fixation and instability, and to know the factors which affected to the enlargement of the femoral tunnels. Total 39 patients were retrospectively reviewed for tunnel measurements radiologically at one year post-operation. (27 patients received bone-patellar tendon-bone autograft, 12 patients received bone-patellar tendon-bone autograft and Kennedy LAD-ligament augmentation device). The surgery was performed using an arthroscopic single and double incision technique. AP and lateral X-rays were obtained and the tunnels were measured by two independent observers using a digital caplper. The measurements were made at the widest part of the tunnel. Correction for magnification was performed by comparing the measured width of the interference screw used for fixation of the graft with its actual width. Statistical analysis was performed using a one-way analysis of variance(ANOVA) and t-test. 1. Radiographic tunnel enlargement of femoral side was average 2.42 mm (bone-patellar tendon-bone autograft : 2.36 mm, Kennedy-LAD and autograft : 2.56 mm)(p>0.05). 2. According to the position of the interference screw, the femoral tunnel enlargement were 2.25 mm in anatomical fixation, 2.40 mm in mid-tunnel fixation, 2.62 mm in mid-tunnel fixation, 2.62 mm in outer-tunnel fixation(p < 0.05). 3. The femoral enlargement according to the overall results(Clancy, 1982) were 2.39 mm in above good result group and 2.50 mm in below fair result group(p < 0.05). Tunnel enlargement group of femoral side was related to a distance between femoral articular surface and the position of interference screw. We conclude that femoral tunnel enlargement following arthoscopic bone tendon-bone ACL reconstruction is related to the mechanical effect rather than the properties of grafts and the clinical results.
Autografts ; Humans ; Knee ; Retrospective Studies ; Transplants

OBJECTIVE: In recent years, the neurosurgeon's role in managing cerebrovascular diseases (CVD) has becomes rapidly challenged and overlapped with other specialists. Furthermore, the patterns of CVD and patient recruitment have also changed. We conducted a retrospective study regarding the practical trends of CVD with reference to the management paradigms at our institute. METHOD: We reviewed all the available data, including the annual reports, the daily department records, the medical records and the radiographic films of the CVD patients who had been admitted to our Neurosurgery Department during the five years between Jan. 2004 and Dec. 2008. RESULTS: The total numbers of CVD operations showed a slight initial increase, but then they remained steady for the latter 3 years. The number of cases of non-angiomatous hemorrhage has been relatively steady, regardless of surgery. The total numbers of treated aneurysms increased, but the main body of this increment was attributed to the initiation of endovascular treatment and increased identification of unruptured vascular lesions. Vascular malformations were sustained with a small number of cases due to referring them to other institutes for radiosurgery, except for the cases that required urgent hemorrhagic evacuation. CONCLUSION: Hemorrhagic CVDs tended to decrease either due to increasing identification before rupture or shifting such patients into a large volume hospital. The increasing awareness of ischemic CVD, the early detection of unruptured aneurysms, and the separation of medical responsibilities from neurologists have all pushed neurosurgeons to make treatment plans in a more cooperative fashion, instead of a competitive way. Neurosurgeons should be furnished with several revolutionary surgical options to widen their scope of managing patients with CVD.
Academies and Institutes ; Aneurysm ; Hemorrhage ; Humans ; Infarction ; Intracranial Aneurysm ; Medical Records ; Neurosurgery ; Patient Selection ; Radiosurgery ; Retrospective Studies ; Rupture ; Specialization ; Subarachnoid Hemorrhage ; Vascular Malformations ; X-Ray Film

The spinal fusion is used for correcting malformations, stabilizing unstable segments, and suppressing the progression of disease, but it causes more load on the adjacent segment and as a result, the degenerative changes accelerate. Furthermore, the accelerated changes case spinal stenosis, degradation of nucleus pulposus, degenerative spondylolisthesis, acquired isthmus defect, and arthritis of articular facet, it rarely needs surgical treatment. The purpose of this study is to know the effect of the fusion level and range on the adjacent segment, to be a standard for determining the fusion range prior to operation, and to help to find the complication like degenerative changes by measuring the range of motion on the adjacent segment after the spinal fusion. Authors analyzed the result of 29 cases of posterolateral lumbar spinal fusion which were operated from February 1989 and January 1994. The intervertebral angle was measured on the flexion and extension lateral radiographs, and the calculated angular motion and sagittal plane rotation at follow-up periods were compared with those of preoperative values. The results were as follows; 1. Among the adjacent segm0ent, the increment of angular motion of superior adjacent segment was 2.6°(-5°~15°) which was higher than that of inferior one with 1.5°(-3°~7°) 2. The increment of angular motion of superior adjacent segment for 1 segment rather than 2 or 3 segments was more than two times with 3.9°(-2°~15°) 3. Regardless of level and range of fusion, the increment of angular motion was 3.0°(-2°~8°) on 4.5th lumbar segment which was increased mostly and 1.5°(-3°~7°) on 5th lumbar and 1st sacral segment which was increased leastly. 4. There were 3 cases showed instability at the superior adjacent segment and no cases showed instability at the inferior adjacent segment among all the cases showing stability prior to operations. In conclusion, the sagittal plane rotation was increased in adjacent segment after posterolateral spine fusion. So, we would recommend that the adjacent segment is very important to the decision of fusion extent and level.
Arthritis ; Follow-Up Studies ; Range of Motion, Articular ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis

The purpose of this study are to delineate the temporal and spatial changes of bone mineralization at the distraction gap and adjacent parent bone, and to investigate the effect of microaxial dynamization on regenerate bone healing and on development of regional osteopenia at the adjacent parent bone, during callotasis. Sixteen Korean adult mongrel dogs underwent bilateral tibial lengthening by callotasis. To the right hindlimbs, no dynamization was applied and served as control group (group I, and axial elastic dynamization was conffered to the left hindlimbs (group II). Bone mineral density(BMD) was measured by dual X-ray absorptionmetry(DXA) at immediate post-operative day, post-operative 12 day, 22 day, 36 day, 50 day, 65 day, and 85 day. Quantitative computed tomogram(Q-CT) was also taken after sacrifice to analyze temporal changes of mineralization pattern in the distraction gap. The following results were obtained; 1. In both group I and II, the BMD was lowest at the interzone in the distraction gap and increased linearly toward the corticotomy surface. This pattern did not change with time until the consolidation of the distraction gap, but the difference of BMD between the interzone and adjacent parent bone decreased with progress of consolidation. 2. During the distraction period, BMD increased progressively at the distraction gap and adjacent parent bone in both group I and II. During consolidation period, although BMD of the distraction gap still increased progressively, that of the adjacent parent bone decreased progressively in group I; the more distant from the corticotomy surface, the more decreased the relative BMD. in group II, the decrease in BMD of the adjacent parent bone was less than that in group I which was statistically significant in mid-consolidation period. In conclusion, the new bone in the distraction gap during callotasis appeared to form in bilateral direction with linear gradient from interzone toward corticotomy surface. Dynamization during callotasis not only stimulated regenerate bone healing in the distraction gap, but also prevented the occurrence of transient regional osteopenia at the distant part of the adjacent bone during midconsolidation period.
Adult ; Animals ; Bone Density ; Bone Diseases, Metabolic ; Calcification, Physiologic ; Dogs ; Hindlimb ; Humans ; Miners ; Osteogenesis, Distraction ; Parents ; Tibia

In order to identify the relationship between the patient's age and the presence of another disease, and the postoperative complications and mortality, we reviewed the medical records of 6156 patients admitted to the Department of Surgery, Dae Jeon Eul Ji General Hospital, during the period from January 1991 through December 1995. There were 1546 geriatric patients(>65 years of age) and 4610 adult patients (age between 16 and 64). Six hundred sixty-five patients (43%) in the geriatric group had one or more concurrent diseases preoperatively, whereas 1127 patients (24.4%) in adult group did. Postoperative complications were more frequent in the geriatric group: 21.6% (310 patients) in the geriatric group vs 15.2%(217 patients) in the adult group. Geriatric patients who had more than one concurrent disease and who underwent an emergency operation showed a higher postoperative complication rate than those who had only one concurrent disease and who underwent elective surgery. The postoperative mortality was also higher in the geriatric group: 3.8%(48 patients) in the geriatric group vs 0.7% (32 patients) in the adult group. The most frequent cause of postoperative death in the geriatric group was sepsis. The geriatric patients who had a concurrent disease account for 16.4% of postoperative complications and 1.5% of the mortalities, whereas those who did not have any concurrent disease account for 2.67% and 0.2%, respectively. Among 1127 adult patients who had a concurrent disease, 124 (11.0%) had postoperative complications and 24 (2.2%) died postoperatively. In conclusion, the elderly patients more frequently had one or more concurrent diseases, and these patients had higher postoperative complication and mortality rates, especially after emergency operations. Accordingly, it is crucial for the surgeon to completely evaluate and manage any concurrent diseases in elderly patients preoperatively.
Adult ; Aged ; Daejeon ; Emergencies ; Hospitals, General ; Humans ; Medical Records ; Mortality ; Postoperative Complications ; Sepsis

BACKGROUND: Hypertension is one of the common diseases which family physicians encounter to manage. Various research proved that appropriate aerobic exercise had effect on lowering blood pressure efficiently. This study was to find out the status of exercise, the change of exercise according to time and its predicting factors in hypertensive patients. METHODS: A total of 193 of the followed-up hypertensive patients of family physicians in Seoul and kyoungkido from May 11, 2001 to June 10, 2001 were interviewed by doctor according to the previously designed structured questionnaire. RESULTS: Eighty two patients (42.57) were male and mean and was 57.4 +/- 9.9 fears. Using Kaplan-Meier's method, 8% of non-exercise group (N= 115) in diagnosing hypertension started exercise after 1 fear and 40%, after 5 years. Otherwise, 5% of exercise group(N=78) stopped exercise after 1 year and 30%, after 5 years. The characteristics of 5 exercise groups according to sex, age, level of education and adequacy of exercise showed significant difference. In average blood pressure, lately started group showed the lowest (137/84 mmHg) and non-exercise group, the highest (146/91 mmHg) In the degree of recommendation. sporadic group showed the highest and non-exercise group, the lowest which showed significant difference (p =0.0024) . CONCLUSION: I conclude that lately started group among non-exercise group and continuous exercise group were mainly affected by recommendation to exercise of physician. As well as exercise, other nonpharmacologic treatment should be promoted by physician as an important strategy for treatment of hypertension.
Blood Pressure ; Education ; Exercise ; Gyeonggi-do ; Humans ; Hypertension ; Male ; Physicians, Family* ; Seoul ; Surveys and Questionnaires

We report a case of Mycobacterium(M.) fortuitum infection in a 65-year-old female who presented with erythematous to purplish colored tender nodules and plaques with curst and purulent discharge on both upper and lower extremities along the sites of acupuncture. The culture of surgically excised specimen in 3% Ogawa media yielded slightly yellowish colored colonies within 2 days. Several tests for identification of the species were performed and growth on 5% NaCl, negative niacin test, positive results in nitrate reduction, catalase, urease and iron uptake tests were noted. Excision of the lesions followed by administration of minocycline and ciprofloxacin showed no sign of relapse to data a year after treatment.
Acupuncture* ; Aged ; Catalase ; Ciprofloxacin ; Female ; Humans ; Iron ; Lower Extremity ; Minocycline ; Mycobacterium fortuitum* ; Mycobacterium* ; Niacin ; Recurrence ; Urease

No abstract available.
Thioacetamide*

The medial collateral ligament(MCL) of the knee is the well established secondary restraint to the anterior displacement of the knee joint. However, there has been no report about the estimation of the anterior displacement in combined ACL(anterior collateral ligament) and MCL injures according to period when they were treated with conservative measures. This prospective study evaluated the changes of anterior displacement over time in combined ACL/MCL injury as the MCL injury heals after initial conservative measures. 19 patients who had combined ACL/MCL injury were followed during twelve months after injury. All patient had a positive Lachman test and were evaluated the side to side differences on KT-2000 knee arthrometer(Medmetric, San Diego, California) testing under 20 Ibs anterior tibial loading at 30 degree knee flexion. The stability of the knee was assessed using KT-2000 knee arthrometer every 8 weeks with clinical examination prospectively. They were treated with CI (Combined instability) brace (Smith & Nephew, Carlsbad, California) as conservative measures. Overall, Initial side to side difference of the anterior displacement was averaged 5.21mm (range,4.0-7.0mm) and 3.30mm (range,2.0-5.5mm) finally. According to the classification of MCL injury, in Grade III groups, they had the greatest initial anterior displacement about 6.4mm, but tight- ened the most to 3.08mm finally. In Grade II and Grade I groups they showed 2.97mm and 2.13mm side to side difference (p>0.01). However in Grade I, the anterior displacement were decreased by 4 months after injury but, it were increased at 6 months after injury. In Grade II and III, the decrement of the anterior displacement were continued by 6 months after injury, but they were not changed after that. The data was analyzed by General Linear Model Procedure method. Conclusively, the anterior displacement of knee in patients with combined ACL/MCL injury was diminished with the time in the majority of patients as the MCL healed. It means that the MCL was the stabilizer to the anterior displacement of the knee under the anterior tibial loading.
Braces ; Classification ; Humans ; Knee Joint ; Knee* ; Linear Models ; Prospective Studies