PURPOSE: To evaluate the results of surgical treatment for diaphyseal fractures of both forearm bones in adolescents. MATERIALS AND METHODS: Between March 2005 and February 2009, fifteen adolescents with diaphyseal fractures in both forearm bones were treated with a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures. They were clinically and radiologically evaluated retrospectively. RESULTS: The mean time for radiological bone union was 9.2 weeks. At the last follow up, the rotational deformity and angulation were within seven degrees and evaluations of the functional results were excellent in all cases. One patient had a refracture of the ulna after plate removal, which was treated with a long-arm cast. CONCLUSION: The use of a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures can be an effective method for unstable displaced diaphyseal fractures of both forearm bones in adolescents.
Adolescent ; Congenital Abnormalities ; Follow-Up Studies ; Forearm ; Humans ; Ulna

PURPOSE: To evaluate the results of surgical treatment for diaphyseal fractures of both forearm bones in adolescents. MATERIALS AND METHODS: Between March 2005 and February 2009, fifteen adolescents with diaphyseal fractures in both forearm bones were treated with a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures. They were clinically and radiologically evaluated retrospectively. RESULTS: The mean time for radiological bone union was 9.2 weeks. At the last follow up, the rotational deformity and angulation were within seven degrees and evaluations of the functional results were excellent in all cases. One patient had a refracture of the ulna after plate removal, which was treated with a long-arm cast. CONCLUSION: The use of a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures can be an effective method for unstable displaced diaphyseal fractures of both forearm bones in adolescents.
Adolescent ; Congenital Abnormalities ; Follow-Up Studies ; Forearm ; Humans ; Ulna

Because additive effects of inhaled corticosteroids and long-acting anticholinergics are unclear, we undertook this study to compare the efficacy of tiotropium alone and tiotropium plus budesonide in patients with chronic obstructive pulmonary disease. The study subjects were randomized to receive either tiotropium 18 microgram once daily with or without budesonide 200 microgram twice daily for 6 weeks. The efficacy variables were changes in trough forced expiratory volume in one second (FEV1), St. George's Respiratory Questionnaire (SGRQ), 6-minute walk distance (6MWD), and use of rescue medication. One hundred patients were randomized and 81 completed the study. The mean age was 64.0 yr, and the mean FEV1 was 39.7% predicted. Compared with tiotropium alone (N=40), the tiotropium/budesonide combination (N=41) was related to an improvement in the SGRQ total score (tiotropium -2.8 units and tiotropium/budesonide -5.6 units, p=0.003). 6MWD was improved by 13.5 m in the tiotropium group and by 22.5 m in the tiotropium/budesonide group (p=0.031). Changes in trough FEV1 and the use of rescue medication were similar between two groups. In conclusion, compared with tiotropium alone, the tiotropium/ budesonide combination was related to an improved health-related quality of life. These data support that low-dose budesonide may enhance the efficacy of tiotropium.
Aged ; Bronchodilator Agents/*administration & dosage ; Budesonide/*administration & dosage ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Models, Statistical ; Pulmonary Disease, Chronic Obstructive/*drug therapy ; Quality of Life ; Questionnaires ; Scopolamine Derivatives/*administration & dosage ; Spirometry/methods ; Treatment Outcome

PURPOSE: This study was performed to compare the clinical results and complications of bipolar hemiarthroplasty and internal fixation using proximal femur nail antirotation (PFNA) for unstable elderly femoral intertrochanteric fractures. MATERIALS AND METHODS: From May 2008 to September 2010, 74 patients older than 65 years who underwent bipolar hemiarthroplasty(33 patients) or PFNA(41 patients) and followed for more than 1 year after surgery were enrolled in this study. The mean blood loss during operation, mean operation time, radiological results, clinical results, and complications were analyzed by the Student t-test and Chi-square test to compare the two groups. RESULTS: The volume of blood loss during the operation was statistically lesser in the PFNA group (P<0.05) and operation time was not statistically different between the two groups (p=0.73). The bipolar hemiarthroplasty group showed a statistically better outcome than the PFNA group in the beginning of weight bearing (p<0.05), the hospital stay (p<0.05). The degradations of Koval score and modified Harris hip score of the bipolar hemiarthroplasty group were statistically better than those of the PFNA group (p=0.03, p=0.02). The bipolar hemiarthroplasty group showed a statistically lower incidence of mechanical(9.1%, p=0.01) and general(12.1%, p=0.00) complications than the PFNA group. CONCLUSION: In elderly patients, bipolar hemiarthroplasty is thought to be one of the effective treatments for unstable femoral intertrochanteric fracutures when considering complications and clinical outcomes.
Aged ; Femur ; Hemiarthroplasty ; Hip ; Hip Fractures ; Humans ; Incidence ; Length of Stay ; Nails ; Weight-Bearing

There are few reports on intraneural ganglion, and this malformations mainly occurs in peripheral nerves of the upper and lower extremities. In the lower extremity, it often occurs in the common peroneal nerve, with neurologic symptoms such as motor weakness and sensory changes. We experienced a case of intraneural ganglion of the common peroneal nerve around the fibular head and this was associated with neurologic symptoms, including weakness of the motor power in the ankle and great toe dorsiflexion and sensory change in the foot dorsum. It was successfully treated by complete excision. We report here on this unusual case and we review the relevant literature.
Animals ; Ankle ; Foot ; Ganglion Cysts ; Head ; Lower Extremity ; Neurologic Manifestations ; Paralysis ; Peripheral Nerves ; Peroneal Nerve ; Toes

15-deoxy-delta12,14-PGJ2(15d-PGJ2) is a natural ligand that activates the peroxisome proliferators-activated receptor (PPAR) gamma, a member of nuclear receptor family implicated in regulation of lipid metabolism and adipocyte differentiation. Recent studies have shown that 15d-PGJ2 is the potent anti-inflammatory agent functioning via PPARgamma-dependent and -independent mechanisms. Most postulated mechanisms for anti-inflammatory action of PPARgamma agonists are involved in inhibiting NF-kappaB signaling pathway. We examined the possibility that IL-6 signaling via the Jak-Stat pathway is modulated by 15d-PGJ2 in lymphocytes and also examined whether the inhibition of IL-6 signaling is dependent of PPARgamma. 15d-PGJ2 blocked IL-6 induced Stat1 and Stat3 activation in primary human lymphocytes, Jurkat cells and immortalized rheumatoid arthritis B cells. Inhibition of IL-6 signaling was induced rapidly within 15 min after treatment of 15d-PGJ2. Other PPARgamma-agonists, such as troglitazone and ciglitazone, did not inhibit IL-6 signaling, indicating that 15d-PGJ2 affect the IL-6-induced Jak-Stat signaling pathway via PPARgamma-independent mechanism. Although cycloheximide reversed 15d-PGJ2-mediated inhibition of Stat3 activation, actinomycin D had no effect on 15d-PGJ2-mediated inhibition of IL-6 signaling, indicating that inhibition of IL-6 signaling occur independent of de novo gene expression. These results show that 15d-PGJ2 specifically inhibit Jak-Stat signaling pathway in lymphocytes, and suggest that 15d-PGJ2 may regulate inflammatory reactions through the modulation of different signaling pathway other than NF-kappaB in lymphocytes.
Arthritis, Rheumatoid/metabolism/pathology ; Chromans/pharmacology ; Cycloheximide/pharmacology ; DNA-Binding Proteins/*metabolism ; Dactinomycin/pharmacology ; Gene Expression Regulation ; Humans ; Hypoglycemic Agents/pharmacology ; Interleukin-6/*pharmacology ; Jurkat Cells/metabolism/pathology ; Lymphocytes/cytology/*drug effects/*metabolism ; NF-kappa B/metabolism ; PPAR gamma/metabolism ; Phosphorylation ; Prostaglandin D2/*analogs & derivatives/pharmacology ; Protein Synthesis Inhibitors/pharmacology ; Research Support, Non-U.S. Gov't ; *Signal Transduction ; Thiazolidinediones/pharmacology ; Trans-Activators/*metabolism

PURPOSE: Authors aim to examine the clinical characteristics and relevant factors of the bacterial meningitis with the complication of subdural effusion. METHODS: We identified the 63 children with bacterial meningitis from 2006 to 2011. Thirteen children (group A) had a complication of subdural effusion during the treatment and 50 children (group B) did not. We reviewed their medical records retrospectively regarding demographic profiles, clinical features and laboratory findings. RESULTS: The mean age was younger in group A than in group B (4.9+/-10.1 vs 27.2+/-46.5 months, P=0.046). Of the initial symptoms, fever was the most frequent symptom, while seizures (30.8% vs 8.0%, P=0.028) and lethargy (38.5% vs 16.0%, P=0.070) were more common in group A. Since the antibiotics medication, the duration of vomiting (2.5+/-1.5 vs 1.1+/- 0.3 days, P=0.003) and irritability (2.5+/-1.5 vs 1.1+/-0.3 days, P=0.034) was longer in group A. Initial laboratory findings were significantly different between two groups with elevation of CRP (9.4+/-8.6 vs 4.1+/-6.6 mg/dL, P=0.010), CSF neutrophil ratio (71.2+/-16.4 vs 54.1+/-33.4%, P=0.041), and CSF protein (260.2+/-192.5 vs 119.9+/-148.5 mg/dL, P=0.003) in group A. Follow-up examination showed that CRP (9.3+/-10.4 vs 2.7+/-5.5 mg/dL, P=0.011), CSF cell count (670.6+/-1,014.0 vs 123.5+/-243.8 /mm3, P=0.006), and CSF protein (211.5+/-148.3 vs 82.1+/-85.8 mg/dL, P=0.002) were significantly higher in group A. CONCLUSION: Some significantly different results were shown in the comparison of initial symptoms and their durations and laboratory findings between the patients with subdural effusion following bacterial meningitis and those without subdural effusion.
Anti-Bacterial Agents ; Cell Count ; Child ; Fever ; Follow-Up Studies ; Humans ; Infant ; Lethargy ; Medical Records ; Meningitis, Bacterial ; Neutrophils ; Retrospective Studies ; Seizures ; Subdural Effusion ; Vomiting

A extrapulmonary small cell carcinoma is a very rare disease, and a primary pleural manifestation is extremely rare. A diagnosis of a small cell carcinoma should be based on the cell morphology, histological pattern, and an immunohistochemical study. We recently experienced a case of small cell carcinoma (SCC) of the pleura in a 59-year-old man who had suffered from right pleuritic chest pain. A histopathological confirmation of SCC was made by a video-associated thoracoscopic lung biopsy. Systemic chemotherapy with etoposide and cisplatin was initiated.
Male ; Humans

PURPOSE : Human uteroglobin (hUG) is a cytokine-like multifunctional protein that possesses potent immunomodulatory and anti-tumor activity. And, the G38A polymorphism of uteroglobin exon 1 has been associated with the development of immunoglobulin A nephropathy, systemic lupus erythematosus and bronchial asthma. In addition, the 38AA genotype has been related to lower serum levels of uteroglobin than the GG or GA genotypes. Although the hUG gene is one of the candidate tumor suppressors in lung cancer, the uteroglobin gene polymorphism has not been reported upon in lung cancer. Therefore, we studied the frequencies of the G38A polymorphism of the hUG gene in patients with lung cancer and control subjects to investigate its relation with lung cancer. MATERIALS AND METHODS : A matched case control design study was adopted to investigate the possibility of an association between primary lung cancer and the G38A polymorphism. To exclude the possible influence of tobacco smoke exposure, or of age or gender on the development of lung cancer, these factors were matched between the 60 patients and the 60 controls. Genotypes were determined by polymerase chain reaction followed by restriction fragments length polymorphism analysis for the hUG gene. RESULTS : The frequency of the 38A allele in patients was 0.55, which was significantly different from its frequency of 0.37 in controls (p=0.007). Moreover, the frequency of the 38AA genotype was significantly higher in patients (35%) than in controls (15%) (p=0.01). Furthermore, two patients previously diagnosed as having prostate cancer were all genotyped as 38AA. CONCLUSION : The G38A polymorphism of the hUG gene is associated with the development of primary lung cancer in Koreans
Alleles ; Asthma ; Case-Control Studies ; Exons ; Genotype ; Glomerulonephritis, IGA ; Humans* ; Lung Neoplasms* ; Lung* ; Lupus Erythematosus, Systemic ; Polymerase Chain Reaction ; Prostatic Neoplasms ; Smoke ; Tobacco ; Uteroglobin*

BACKGROUNDS/AIMS: Standard liver volume (SLV) is an important parameter that has been used as a reference value to estimate the graft matching in living donor liver transplantation (LDLT). This study aimed to determine a reliable SLV formula for Korean adult patients as compared with the 15 SLV formulae from other studies and further estimate SLV formula by gender and body mass index (BMI). METHODS: Computed tomography liver volumetry was performed in 1,000 living donors for LDLT and regression formulae for SLV was calculated. Individual donor data were applied to the 15 previously published SLV formulae, as compared with the SLV formula derived in this study. Analysis for confounding variables of BMI and gender was also performed. RESULTS: Two formulae, "SLV (ml)=908.204xBSA-464.728" with DuBois body surface area (BSA) formula and "SLV (ml)=893.485xBSA-439.169" with Monsteller BSA formula, were derived by using the profiles of the 1,000 living donors included in the study. Comparison with other 15 other formulae, all except for Chouker formula showed the mean volume percentage errors of 4.8-5.4%. The gender showed no significant effect on total liver volume (TLV), but there was a significant increase in TLV as BMI increased. CONCLUSIONS: Our study suggested that most SLV formulae showed a crudely applicable range of SLV estimation for Korean adults. Considering the volume error in estimating SLV, further SLV studies with larger population from multiple centers should be performed to enhance its predictability. Our results suggested that classifying SLV formulae by BMI and gender is unnecessary.
Adult* ; Body Mass Index ; Body Surface Area ; Confounding Factors (Epidemiology)* ; Humans ; Liver Transplantation ; Liver* ; Living Donors ; Reference Values ; Tissue Donors ; Transplants