Bone remodeling is characterized by the coupling of osteoclast-mediated bone resorption and osteoblast-mediated bone formation. The process is tightly regualted at the local level by an incompletely known netwotk of peptide and non-peptide fators. Nitric oxide(NO), synthesized by nitric oxide synthetase(NOS) from L-arginine, is becoming recognized as an important bioregualtory molecule in a variety of tissue, but little is known about its possible role in periodontal tissue. The purpose of this study is to investigate the expression of nitric oxide synthetase(NOS) in inflamed gingiva and the effects of cytokine on the expression of NOS protein. The expression of NOS in gingival tissue was evaluated by immunohistochemical staining for NOS1, NOS2, NOS3. The effect of cytokine on the expression of NOS in human periodontal ligament cells and osteoblast-like HOS cells by western blot analysis. Further, we studied that NO functions in periodontal ligment cells as a regulatory molecule. PDL cells incubated with NOS inhibitor and donor. The protein expression, type I collagen & non-collagenous protein, nitrate production and cell proliferation were evaluated The results were as follows. 1. NOS1, NOS2, NOS3 was rarely distributed in healthy gingiva, but stronger stained in gingival epithelium, endothelial cells, and mononuclear cells of inflammed gingiva. 2. The cytokine stimulated NOS1, and NOS3 protein were not inducing or inhibitory effect to compared with control in PDL and HOS cells. 3.Incubation of cells with combination of TNF-alpha, IFN-gamma, LPS result in a time dependant increase in NOS2 expression, reaching a maximal level after 24 hours of stimulation. 4. The osteonectin protein inhibitory effect of NMA, inhibitor of NOS, was reversed by Larginine in dose dependant manner. 5. NMA decreased cell proliferation and nitrate production, but the inhibitory efffect of NMA was also prevented by the NO donor, sodium nitropruiside. These results suggest that exogenously synthesized NO was playing a stimulating effect on cell proliferation or on non-collagenous protein expression. Therefore NO have an important role in mediation of localized bone destruction associated inflammatory bone disease such as periodontitis
Arginine ; Blotting, Western ; Bone Diseases ; Bone Remodeling ; Bone Resorption ; Cell Proliferation ; Collagen Type I ; Endothelial Cells ; Epithelium ; Gingiva ; Humans ; Negotiating ; Nitric Oxide Synthase* ; Nitric Oxide* ; Osteogenesis ; Osteonectin ; Periodontal Ligament ; Periodontitis ; Sensitivity and Specificity* ; Sodium ; Tissue Donors ; Tumor Necrosis Factor-alpha

We observed a 51-year-old male, who developed depigmented patches on the lower abdomen after photochemotherapy(PUVA) of psoriasis without evidence of phototoxic reaction. The depigmented patches did not orginate from the sites of previous psoriatic lesions. Fontana-Masson stain of the biopsy specimen revealed nearly absent melanin pigments in the epidrmis of the hypopigmented patch, while lots of pigments were obsereved on the surrounding hyperpigmented area. Electron micrograph showed no melanocytes in the hypopigmented patch. Thus we report this case as having vitiliginous patches induced by photochemotherapy of psoriasis.
Abdomen ; Biopsy ; Humans ; Male ; Melanins ; Melanocytes ; Middle Aged ; Photochemotherapy* ; Psoriasis* ; Vitiligo

PURPOSE: To investigate which spectral domain optical coherence tomography (SD-OCT) findings predict visual outcome after anti-vascular endothelial growth factor (VEGF) treatment in neovascular age-related macular degeneration (NV-AMD). METHODS: We reviewed the medical records of patients with treatment-naive NV-AMD who underwent three or more consecutive anti-VEGF injections. The patients were divided into three groups according to their changes of visual acuity (VA); improved (group I), static (group S), or worsened (group W). We assessed the incidences and values of all available SD-OCT findings of these groups, compared these findings between the three groups and compared the initial values with the post-treatment values. RESULTS: Better initial VA and longer external limiting membrane (ELM) length were associated with less change in VA after anti-VEGF treatment. The initial VA was mildly correlated with initial photoreceptor inner and outer segment junction (IS/OS) length and initial ELM length. The final VA was also mildly correlated with the final IS/OS length and the final ELM length. VA was significantly changed after anti-VEGF treatment in groups W and I. With regard to incidence, disruption of the IS/OS (IS/OS-D), disruption of the ELM (ELM-D) and ELM length differed significantly between the three groups, particularly ELM-D. The incidences of IS/OS-D and ELM-D in group I were significantly lower than those in groups S and W, and those in group S were also lower than those in group W. The ELM length in group I was significantly longer than it was in groups S and W, and the ELM length in group S was longer than that for group W. However, these three findings did not change after the anti-VEGF treatment. CONCLUSIONS: Initial IS/OS-D, ELM length and particularly ELM-D can be useful predictors of the visual outcome after anti-VEGF treatment in NV-AMD patients.
Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/*therapeutic use ; Choroidal Neovascularization/*drug therapy/physiopathology ; Female ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Ranibizumab/*therapeutic use ; Retinal Photoreceptor Cell Inner Segment/pathology ; Retinal Photoreceptor Cell Outer Segment/pathology ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/*physiology ; Wet Macular Degeneration/*drug therapy/physiopathology

Fractures of the tibia are frequently encountered in mordern civilized society. Especially, those in distal 1/3 of the tibia have so many problems, such as angular deformity, osteomyelitis and nonunion because of anatomically scanty soft tissue. Many modalities of the treatment of fracture of distal 1/3 of the tibia were introduced. Among them, interlocking IM nailings were considered as one of the best modality. But, in interlocking IM nail, reaming of the medullary canal which destroys the endosteal circulation and causes thermal necrosis of the inner aspect of the cortical bone results in delayed union. And also, procedure for distal screw fixation is difficult and time-consuming. As for using flexible IM nails for fractures of distal 1/3 of the tibia, it was considered as not so satisfactory method due to lack of stability of fixation. However, the stability of fixation can be strengthened with fanning of the nails in distal fragment, using more than 3 nails and delay the protected weight bearing. Authors studied 25 cases of fractures of distal 1/3 of the tibia treated with closed flexible IM nailing at Sung Ae General Hospital, from July., 1987 to July., 1989, and obtained following results: 1. Among 25 cases, 4th decades were most common and males were more commonly involved. 2. Traffic accidents were the most common causes of injury and majority of 16 open fractures and 19 comminuted fractures, were caused by high energy mechanism. Among open fractures, type II were most common. 3. Two angular deformities less than 10 degrees, one proximal migration and one checkrein deformity were observed as complications, but, no clinically significant complications were noted. 4. The time for radiological union were 14.5 weeks in group without fibular fracture and 15.1 weeks in group with fibular fracture, and 14.0 weeks in closed fracture group and 17.2 weeks in open fracture group, and average in 15.6 weeks.
Accidents, Traffic ; Clinical Study ; Congenital Abnormalities ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Hospitals, General ; Humans ; Male ; Methods ; Necrosis ; Osteomyelitis ; Tibia ; Weight-Bearing

No abstract available.
Bursitis*

PURPOSE: Intravitreal injection of bevacizumab (Avastin(R)) can lead to several intraocular complications including endophthalmitis, hemorrhage and inflammation. We present one case of acute anterior uveitis with hypopyon in an HLA-B27(+) patient following intravitreal injection of bevacizumab. CASE SUMMARY: A 40-year-old male with known central retinal vein occlusion presented with redness and decreased visual acuity in the left eye. Symptoms had developed 4 days earlier after the sixth intravitreal injection of bevacizumab in that eye. The patient had a marked anterior chamber reaction with hypopyon and posterior synechiae. Nine days after onset, similar symptoms in the left eye occurred in the uninjected right eye. Through examination and clinical manifestations, we diagnosed acute anterior uveitis associated with HLA-B27 positivity. The patient was treated with 1% prednisolone acetate, 0.5% moxifloxacin and 1% atropine in both eyes and all symptoms had resolved after 6 weeks.
Adult ; Anterior Chamber ; Atropine ; Endophthalmitis ; Hemorrhage ; HLA-B27 Antigen* ; Humans ; Inflammation ; Intravitreal Injections* ; Male ; Prednisolone ; Retinal Vein ; Uveitis, Anterior* ; Visual Acuity ; Bevacizumab

PURPOSE: To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. MATERIALS AND METHODS: We retrospectively reviewed effectivenss of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n=4), ruptured bullae (n=2), and histiocytosis-X(n=l). Three patients had iatrogenic pneumothorax caused by trauma (n=l) and surgery(n=2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. RESULTS: All catheters were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. CONCLUSION: Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.
Catheters* ; Chest Tubes* ; Drainage* ; Fluoroscopy* ; Humans ; Pneumothorax* ; Retrospective Studies ; Thoracotomy ; Thorax* ; Tuberculosis

PURPOSE: To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. MATERIALS AND METHODS: We retrospectively reviewed effectivenss of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n=4), ruptured bullae (n=2), and histiocytosis-X(n=l). Three patients had iatrogenic pneumothorax caused by trauma (n=l) and surgery(n=2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. RESULTS: All catheters were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. CONCLUSION: Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.
Catheters* ; Chest Tubes* ; Drainage* ; Fluoroscopy* ; Humans ; Pneumothorax* ; Retrospective Studies ; Thoracotomy ; Thorax* ; Tuberculosis

We experinced a case of 4p+ syndrome in male infant. He had multiple anomalies such as flat occiput, hypertelorism, low set malformed ear, lower anterior hair line, depressed nose, broad nasal bridge, bilateral complete cleft lip and palate, short neck, unusual position of fingers, ventricular septal defect and umblical hernia. He menifested growth and developmental retardation. Karyotype with banding revealed an extra short arm of chromosome 4. The mother's karyotype was normal. His father and father's sister had a translocation between the short arm of chromosome 4 and the short arm of chromosome 9; their karyotypes were 46, XY, t(4;9) and 46, XX, t(4;9), respectively. In this case, trisomy 4p was the result of parental balanced translocatiom. As this is the first case in Korea, it is worthwhile to report with reviewing literature.
Arm ; Chromosomes, Human, Pair 4 ; Chromosomes, Human, Pair 9 ; Cleft Lip ; Ear ; Fathers ; Fingers ; Growth and Development ; Hair ; Heart Septal Defects, Ventricular ; Hernia ; Humans ; Hypertelorism ; Infant ; Karyotype ; Korea ; Male ; Neck ; Nose ; Palate ; Parents ; Siblings ; Trisomy

PURPOSE: It is important for the physician and a rape counselor to understand epidemiology studies of the incidence, prevalence, spread, prevention, and control of sexual assault in a local community or a specific group of individuals. We did this study in order to find an effective treatment for the sexual assault victims and to establish a data base on them. METHODS: We prospectively evaluated sexually assaulted patients who visited the Medical Supportive Center for Women at the National Police Hospital from Oct. 11, 2001, to Oct. 10, 2002. The data were obtained from the records of the ER (emergency room) and OB & GY (obstetric & gynecologic) clinic; a total of 169 patients were evaluated. RESULTS: The mean age was 20.1 years old. The age distribution of sexual assault victims was divided into four: 14 cases under 7 years of age (8.3%), 26 cases between ages 7 and 13 years (15%), 43 cases between ages 14 and 19 years (26.3%), and 86 cases over 20 years of age (52.6%). Of the patients, 157 (92.9%) were unmarried and 117 (69.2%) were examined within 1 hour after visiting the hospital. The physical injuries were 15 vaginal injuries (26.9%), 34 ruptures of the hymen (16.9%), 1 sexually transmitted disease (0.6%), 57 abnormal sensations of the genital organ (28.3%), and 55 minor injuries including abrasions, contusions, and lacerations (27.3%). The psychological injuries were 105 phobias (21.4%), 92 anxieties (18.8%), 68 angers (13.9), 51 guilts (10.4%), and the like. Eighty-eight patients (52.1%) were acquainted with the assailant. CONCLUSION: Optimal management of sexual assault victims should involve continuous epidemiologic analysis and the estalishment of an assault-victim data base.
Age Distribution ; Anger ; Anxiety ; Contusions ; Counseling ; Epidemiology ; Female ; Genitalia ; Guilt ; Humans ; Hymen ; Incidence ; Lacerations ; Phobic Disorders ; Police ; Prevalence ; Prospective Studies ; Rape ; Rupture ; Sensation ; Sexually Transmitted Diseases ; Single Person