No abstract available.
Contracture* ; Mastectomy* ; Seroma*

Recently autogenous nerve graft was usually used for segmental defect of peripheal nerve injury. In case of inappropriate size or amount of donor nerve graft, there were many studies included nerve regeneration with special nerve conduit material. To compare the result of autogenous nerve graft with that of silicone tubing method in segmental defect of sciatic nerve, the experiments were carried out on adult rats with autogenous nerve graft on the left side and silicone tubing on the right side. The results were as follows; 1. Myelinated nerve fibers were larger in silicone tubing method than autogenous nerve graft at postop. 4 weeks. 2. There was no difference in nerve regeneration in both groups at postop. 12 weeks. 3. Some atrophic changes were showed in denervated muscles in both groups at postop. 4 weeks. Skeletal muscle changes between the two groups were meagre. 4. Perineural adhension was rare in silicone tubing group in contrast to autogenous nerve graft group. 5. Nerve Conduction Velocity was similar between autogenous nerve graft and silicone tubing method after 4 weeks postoperatively. In conclusion, this study suggests that silicone tubing can be useful method to repair the large nerve gaps and has a potential clinical utilization in large segmental nerve defect.
Adult ; Animals ; Autografts ; Humans ; Methods ; Muscle, Skeletal ; Muscles ; Nerve Fibers, Myelinated ; Nerve Regeneration ; Neural Conduction ; Rats ; Sciatic Nerve ; Silicon ; Silicones ; Tissue Donors ; Transplants

STUDY DESIGN: Retrospective case series. OBJECTIVES: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). SUMMARY OF LITERATURE REVIEW: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. MATERIALS AND METHODS: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. RESULTS: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the follow-up period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p < 0.05). Complications were not reported in any cases. CONCLUSIONS: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.
Back Pain ; Consensus ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Nerve Block ; Quality of Life ; Retrospective Studies ; Treatment Outcome

Candida vertebral osteomyelitis (CVO) is a rare disease that is a complication of intravenous drug use, but recently it has been recognized as mostly an opportunistic infection. Because CVO appears to mimic pyogenic spondylodiscitis in terms of the clinical and radiologic presentations, it is often neglected in a usual clinical setting. The clinical, radiological, and biological characteristics of CVO are often used to make a differential diagnosis with vertebral osteomyelitis from other etiologies. Once an initial proper diagnosis was performed, the treatment relies on the prompt initiation of appropriate pharmacotherapy and serial monitoring of the clinical progress. This paper report late-onset CVO in two young patients who underwent a heart transplant surgery and had postoperative systemic candidiasis. These two cases are a good reminder of the potential of CVO in immunosuppressive patients treated with anti-fungal agents. This paper presents these two cases with a review of the relevant literature.
Candida ; Candidiasis ; Diagnosis ; Diagnosis, Differential ; Discitis ; Drug Therapy ; Heart Transplantation ; Heart ; Humans ; Opportunistic Infections ; Osteomyelitis ; Population Characteristics ; Rare Diseases

OBJECTIVES: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs).SUMMARY OF LITERATURE REVIEW: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. MATERIALS AND METHODS: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. RESULTS: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the follow-up period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p < 0.05). Complications were not reported in any cases. CONCLUSIONS Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.

BACKGROUND: South Korea is rapidly being an aging-society and the demand of long-term care insurance services for elderly patients is rising. In addition, because the elderly taking multiple medicines, the adherence is lowered and the adverse events are easily occurred. Therefore, many are interested in introducing the geriatric pharmacy specialist to manage this situation. PURPOSE: By applying a similar program such as the geriatric pharmacy specialist working in nursing home, we conducted this study to evaluate the potential contribution to both the health insurance services and financial savings for the elderly patients. METHODS: We conducted a trial in an elderly nursing home to collaborate between doctor and pharmacist making a checklist for improving medication adherence and establish a consultation system. Also we applied a smart phone application in the pharmaceutical care processes. RESULTS: Thereby completing the drug therapy related checklist apply to nursing facilities in South Korea. And we got a performance that improves medication adherence when used in the clinical practice settings. CONCLUSION: By introducing a training program of pharmacy care managers and geriatric professionals such as the United States and Japan, we revealed the elderly nursing home residents and vulnerable elderly people living alone were improved the medication adherence and it will contributed to the health and quality of life of the patients.
Aged* ; Checklist ; Drug Therapy ; Education ; Humans ; Income ; Insurance, Health ; Insurance, Long-Term Care ; Japan ; Korea ; Long-Term Care ; Medication Adherence* ; Nursing Homes* ; Nursing* ; Pharmaceutical Services ; Pharmacists ; Pharmacy ; Quality of Life ; Specialization ; United States ; Smartphone

Oxidative stress has been considered to be a major contributor to the pathogenesis of the diabetic macrovascular and microvascular complications. In the absence of an appropriate antioxidant defense mechanism, increased oxidative stress leads to the activation of stress-sensitive intracellular signaling pathways and the formation of gene products that cause damage and contribute to the late complications ofdiabetes. The source of reactive oxygen species (ROS) in the pancreatic beta cells and insulin sensitive cells has postulated to be the mitochondrial electron transport chain. NAD(P)H oxidase-dependent ROS production is also important as the source both in pancreatic beta cells and other cells. NAD(P)H oxidase mediated ROS can alter parameters of signal transduction, insulin secretion, insulin action, cell proliferation and cell death. Additionally, oxidative stress as the pathogenic mechanism linking insulin resistance with dysfunction of both pancreatic beta cells and endothelial cells, eventually leads to diabetes and its complications. Further investigation of the mechanisms and its therapeutic interventions based on focusing NAD(P)H oxidase associated ROS production in the islet cells and other islet cells are needed
Cell Death ; Cell Proliferation ; Electron Transport ; Endothelial Cells ; Insulin ; Insulin Resistance ; Insulin-Secreting Cells ; Islets of Langerhans ; Mitochondria ; NADPH Oxidase ; Oxidative Stress ; Reactive Oxygen Species ; Signal Transduction

STATEMENT OF PROBLEM: Screw loosening has been a common complication and still reported frequently. PURPOSE: The purpose of this study was to evaluate abrasion of the implant fixture and TiN coated abutment screw after repeated delivery and removal with universal measuring microscope. MATERIAL AND METHODS: Implant systems used for this study were Osstem and 3i. Seven pairs of implant fixtures, abutments and abutment screws for each system were selected and all the fixtures were perpendicularly mounted in liquid unsaturated polyesther with dental surveyor. After 20 times of repeated closing and opening test, the evaluation for the change of inner surface of implant and TiN-coated abutment screw, and weight loss were measured. Mann-Whitney test with SPSS statistical software for Window was applied to analyze the measurement of weight loss. RESULTS: TiN-coated abutment screws of Osstem and 3i showed lesser loss of weight than non-coated those of Osstem and 3i (P < .05, Mann-Whitney test). CONCLUSION: Conclusively, TiN coating of abutment screw showed better resistance to abrasion than titanium abutment screw. It was concluded that TiN coating of abutment screw would reduce the loss of preload with good abrasion resistance and low coefficient of friction, and help to maintain screw joint stability.
Collodion ; Friction ; Joints ; Tin ; Titanium ; Weight Loss

BACKGROUND: The changes of serum TNF-alpha, sTNFR, sIL-2R and sICAM-1 levels have been recently reported in some cancer patients but the clinical significance of these cytokines is not clearly established. To define the changes and clinical significance of these cytokines in patients with hepatocellular carcinoma (HCC), serum levels of TNF- alpha, sTNFR, sIL-2R and sICAM-1 were measured. METHODS: The serum levels of TNF-alpha, sTNFR, sIL-2R and sICAM-1 were measured before and after transarterial chemoembolization (TACE) by enzyme immunoassay in 20 patients with HCC and 10 adult healthy subjects as controls. These patients were divided into two groups, no response (NR, 14 cases) and partial response (PR, 6 cases) on the basis of changes of tumor size, new growth foci on the ultrasonographic or CT findings, and serum levels of alpha-fetoprotein. RESULTS: Serum levels of TNF-alpha, sTNFR, sIft-2R and sICAM-1 were significantly higher in all patients with HCC than in those of adult healthy controls (p<0.01). Serum levels of TNF-alpha after TACE tended in to be higher in comparison with those before TACE in the NR group (p<0.1), but those were not significantly different between before and after TACE in the PR group. Serum levels of sTNFR, sIL-2R and sICAM-1 were not significantly different between after and before TACE in both groups. CONCLUSIONS: These results suggest that serum levels of TNF-alpha, sTNFR, sIL-2R and sICAM:-1 in patients with HCC before therapy are significantly increased, compared with those of the control group, and the measurement of serum TNF-alpha levels may become useful in the diagnosis and monitoring of hepatocellular carcinoma in the future.
Adult ; alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Cytokines ; Diagnosis ; Humans ; Immunoenzyme Techniques ; Tumor Necrosis Factor-alpha*

BACKGROUND: The changes of serum TNF-alpha, sTNFR, sIL-2R and sICAM-1 levels have been recently reported in some cancer patients but the clinical significance of these cytokines is not clearly established. To define the changes and clinical significance of these cytokines in patients with hepatocellular carcinoma (HCC), serum levels of TNF- alpha, sTNFR, sIL-2R and sICAM-1 were measured. METHODS: The serum levels of TNF-alpha, sTNFR, sIL-2R and sICAM-1 were measured before and after transarterial chemoembolization (TACE) by enzyme immunoassay in 20 patients with HCC and 10 adult healthy subjects as controls. These patients were divided into two groups, no response (NR, 14 cases) and partial response (PR, 6 cases) on the basis of changes of tumor size, new growth foci on the ultrasonographic or CT findings, and serum levels of alpha-fetoprotein. RESULTS: Serum levels of TNF-alpha, sTNFR, sIft-2R and sICAM-1 were significantly higher in all patients with HCC than in those of adult healthy controls (p<0.01). Serum levels of TNF-alpha after TACE tended in to be higher in comparison with those before TACE in the NR group (p<0.1), but those were not significantly different between before and after TACE in the PR group. Serum levels of sTNFR, sIL-2R and sICAM-1 were not significantly different between after and before TACE in both groups. CONCLUSIONS: These results suggest that serum levels of TNF-alpha, sTNFR, sIL-2R and sICAM:-1 in patients with HCC before therapy are significantly increased, compared with those of the control group, and the measurement of serum TNF-alpha levels may become useful in the diagnosis and monitoring of hepatocellular carcinoma in the future.
Adult ; alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Cytokines ; Diagnosis ; Humans ; Immunoenzyme Techniques ; Tumor Necrosis Factor-alpha*