After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.
Head* ; Humeral Fractures ; Humerus* ; Incidence ; Intra-Articular Fractures ; Surgeons ; Ulnar Nerve*

No abstract available.

This study was performed to investigate the stimulating effect on oocyte maturation and cumulus cell expansion in TC199 media by human cord serum (HCS) supplementation. Immature mouse oocyte cumulus complexes (OCCs) were cultured in TC199 media supplemented with bovine serum albumin (BSA), HCS and human chorionic gonadotropin (hCG) instead of luteinizing hormone (LH) respectively, and the expression of cumulus expansion and oocyte maturation were observed. After 4hr and 24hr culture with or without OCCs, media containing 0.4% BSA, 10% HCS and 10 lU hCG respectively were collected and analyzed for changing concentrations of estradiol (E2), progesterone(P4), testosterone(T), and PGF2. There were no elevation of E2, T, and PGF2 by OCCs culture, but minute elevation of P4 level by 24hr OCCs culture in hCG supplementation (p=0.048). The stimulating pattern of cumulus expansion of OCCs by HCS and hCG supplementation was similar to our previously report using Ham's F-10 media, however oocyte maturation rates after 24hr OCCs culture in all media were increased by 20~30% compared to Ham's F-10 media. These results suggest that LH in HCS induce cumulus expansion probably by P4 secretion of OCCs, and TC199 is efficient media for immature mouse oocyte maturation.
Animals ; Chorionic Gonadotropin ; Cumulus Cells* ; Dinoprost ; Estradiol ; Humans* ; Luteinizing Hormone ; Mice ; Oocytes* ; Serum Albumin, Bovine

No abstract available.
Antibodies, Antiphospholipid* ; Autoimmune Diseases* ; Humans

No abstract available.
Antibodies, Antiphospholipid* ; Autoimmune Diseases* ; Humans

Reports of osteomyelitis in the proximal humerus with pyogenic glenohumeral arthritis of adjacent joints mostly involve pediatric patients. Nowadays, osteomyelitis that is secondary to adjacent pyogenic glenohumeral arthritis is extremely rare, even more so in adults than in pediatrics. We report a rare case of the pyogenic glenohumeral arthritis followed by osteomyelitis of the proximal humerus in an elderly patient. Initially, we diagnosed a case of pyogenic glenohumeral arthritis only, which, despite arthroscopic synovectomy, did not resolve and severe pain continued. Subsequent radiological imaging, performed after our suspicion of a secondary involvement, allowed us to diagnose osteomyelitis combined with the pyogenic glenohumeral arthritis, which we had overlooked because of the extreme rarity of the condition in adults since the antibiotic era began.
Adult ; Aged* ; Arthritis* ; Arthritis, Infectious ; Humans ; Humerus* ; Joints ; Osteomyelitis* ; Pediatrics ; Shoulder

Hyperinsullinism and the resultant hypoglycemia are hallmarks of functioning beta islet cell tumors of the pancreas. The management of one case of insulinoma during surgery for the removal of the tumor is described and the available literature on the subject reviewed. The outline of the anesthetic management for the insulinoma is as follows: 1) Anesthetists should understand the signs and the symptoms of hypoglycemia and hyperglycemia. 2) Preoprative management: a) infusion of glucose for avoiding hypoglycemia due to NPO after midnight. b) glucocorticosteroid administration with premedications. 3) Operative management: a) continuous determination of blood glucose level may be helpful. b) Maintenance of the glucose level about 50mg% above symptomatic CNS level have the advantage that exicision of the infulinoma can be immediately judged. c) The use of an agent that decreases CMRO2 and does not affect the insulin-glucose ratio is rational choice when concern about hypoglycemia exists. Thiopental-enflurane anesthesia with controlled ventilation maintaining normocarbia is recommended. d) beta-adrenergic blocker. These drugs must be avoided in the hypoglycemic state.
Adenoma, Islet Cell ; Anesthesia ; Blood Glucose ; Glucose ; Hyperglycemia ; Hypoglycemia ; Insulinoma ; Pancreas ; Premedication ; Ventilation

No abstract available.
Ectopia Cordis* ; Ultrasonography*

BACKGROUND: The detection of specific autoantibodies in the sera of patients with systemic rheumatic diseases plays a key role in the differential diagnosis. Enzyme-linked immunosorbent assays (ELISA) is known as sensitive and semiquantitative method to detect autoantibodies and ELISA kits using a recombinant fusion protein as antigen have been developed. So, various commercial ELISA have recently become available in a diagnostic laboratory. We investigated the clinical value of antinuclear autoantibodies using commercial ELISA kits. METHODS: The serum of 90 patients were tested for autoantibodies to SSA/Ro, SSB/La, nRNP/Sm and Sm antigens by ELISA using four commercial kits, EL-ANA(TM) (TheraTest, IL, USA), DIASTAT(TM)(SHIELD, DUNDEE, UK), QUANTALit(TM) (INOVA, CA, USA), Varelisa(TM) (elias, WI, USA). We evaluated the clinical usefulness of panel test of Varelisa(TM) in the diagnosis of systemic rheumatic diseases. RESULTS: The concordance rates of four ELISA kits for autoantibodies to SSA/Ro, SSB/La, RNP/Sm and Sm antigens were 83.6%, 74.5%, 87.5% and 80.0%, respectively. Using panel test of Varelisa(TM), positive rates of autoantibodies to Ul-snRNP, nRNP/Sm, Sm, SSA/Ro, SSB/La, Scl-70, CENP and Jo-1 antigens in SLE were 30.0, 40.0, 33.3, 46.7, 20.0, 20.0, 10.0, and 0%, respectively. Of 30 patients with SLE, 16 (53.3%) were positive for 2 or more antibodies. CONCLUSIONS: EL-ANA(TM), QUANTALite(TM) and Varelisa(TM) show more positive rates than DIASTAT(TM). The difference in the positive rates among four commercial ELISA kits may come from the different antigen sources. The panel test of 8 autoantibodies using Varelisa(TM) ELISA kit offers discriminative power and enhances the specificity of the assay in patients who lack clear evidence of clinically definite autoimmune disease.
Antibodies ; Autoantibodies* ; Autoimmune Diseases ; Diagnosis ; Diagnosis, Differential ; Enzyme-Linked Immunosorbent Assay* ; Histidine-tRNA Ligase ; Humans ; Rheumatic Diseases ; Sensitivity and Specificity ; Staphylococcal Protein A

No abstract available.
Indicators and Reagents*