BACKGROUND: Kirschner's wire (K-wire) transfixation and locking hook plate fixation techniques are widely used in the treatment of acute acromioclavicular joint (ACJ) dislocation. The purpose of this study was to compare the clinical and radiologic outcomes between K-wires transfixation and a locking hook plate fixation technique. METHODS: Seventy-seven patients with acute ACJ dislocation managed with K-wire (56 shoulders) and locking hook plate (21 shoulders) were enrolled for this study. The mean follow-up period was 61 months. RESULTS: At the last follow-up, the shoulder rating scale of the University of California at Los Angeles (UCLA) was higher in patients treated with locking hook plate than with K-wires (33.2 +/- 2.7 vs. 31.3 +/- 3.4, p=0.009). In radiologic assessments, coracoclavicular distance (CCD) (7.9 mm vs. 7.7 mm, p=0.269) and acromioclavicular distance (ACD) (3.0 mm vs. 1.9 mm, p=0.082) were not statistically different from contralateral unaffected shoulder in locking hook plate fixation group, but acromioclavicular interval (ACI) was significant difference. However, there were significant differences in ACI, CCD, and ACD in K-wire fixation group (p<0.001). Eleven complications (20%) occurred in K-wire transfixation group and 2 subacromial erosions on computed tomography scan occurred in locking hook plate fixation group. CONCLUSIONS: ACJ stabilization was achieved in acute ACJ dislocations treated with K-wires or locking hook plates. Locking hook plate can provide higher UCLA shoulder score than K-wire and maintain CCD, and ACD without ligament reconstruction. K-wire transfixation technique resulted in a higher complication rate than locking hook plate.
Acromioclavicular Joint* ; Bone Wires ; California ; Dislocations* ; Follow-Up Studies ; Humans ; Ligaments ; Shoulder

A case of cryptococal hepatitis in a 4-year-old girl was presented with a brief review of the literature. She was admitted with the chief complaints of jaundice, abdominal pain, and semicomatose mental state. Treatment was started including dexamethasone under impression of fulminant hepatitis. During treatment massive G-I bleeding appeared which required eleven pints of blood and 20 days for control. Upper G-I series revealed duodenal ucer. And explolparotomy was performed because of free air in the peritoneum. Operative liver biopsy done at that time revealed many cryptococci in the biopsy tissue. Therefore we treated her with-5-fluorocytosine and the result was good. Follow-up of her for a year and half revealed that she was in here good general condition. Therefore we consider that secondary change in liver such as cirrhosis has not yet occurred in her.
Abdominal Pain ; Biopsy ; Child, Preschool ; Dexamethasone ; Female ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Hepatitis* ; Humans ; Jaundice ; Liver ; Peritoneum

This is a clinical study of 30 cases of congenital malformation of ileum at Severance hospital from 1966 to 1975. They were confirmed after operation and the results were summarized as follows; 1. Total number of patients was 30 cases including 25 males 5 females. Among them 20 cases were included at pediatric agr from birth to 15 years of age. The most frequent occurrence was within 1 month of age with 11 cases. 2. Confirmed diagnesis after operation were 3 cases of ileal duplication,3 cases of ileal stenosis, 2 cases of ileal atresia, 1 cases of ileal hypoplasia, and 21 cases of Meckel's diverticulum. 3. Except for Meckel's diverticuium all the patients were studied which simple abdominal X-ray, which revealed complete and partial intestinal obstruction. Among them 4 cases were found microeolon and narrowing of distal 1 cases of ileum at 1 cases of ileal atresia and 2 cases. 4. After operation, 26 of 30 cases were recovered but 3 cases (atsesia 1, stenosis 1, and hypoplasia 1) were discharged with complications. And 1 case of multiple ileal stencelsdied of sepsis and wound infection.
Constriction, Pathologic ; Female ; Humans ; Ileum* ; Intestinal Obstruction ; Male ; Meckel Diverticulum ; Parturition ; Sepsis ; Wound Infection

BACKGROUND/AIMS: The efficacy of standard triple therapy (STT) in treating Helicobacter pylori infection has decreased. Many investigators have attempted to increase the eradication rate. We investigated the outcomes of concomitant therapy (CT) and STT combined with probiotics (STP) as a first-line treatment for H. pylori infection. METHODS: We reviewed the medical records of 361 patients who received either STP (n=286) or CT (n=75). The STP group received STT combined with a probiotic preparation for 1 week. The CT group received STT and metronidazole for 1 week. RESULTS: The intention-to-treat and per-protocol eradication rates were 83.6% (95% confidence interval [CI], 79.0 to 87.7) and 87.1% (95% CI, 81.2 to 89.7) in the STP group and 86.7% (95% CI, 78.7 to 93.3) and 91.4% (95% CI, 83.6 to 97.1) in the CT group (p=0.512 and p=0.324), respectively. The frequency of adverse effects was higher in the CT group (28.2%) than in the STP group (12.8%) (p=0.002). CONCLUSIONS: STP and CT are encouragingly efficacious as first-line treatments for H. pylori infection. Therefore, adding probiotics to STT may be a feasible option to avoid side effects.
Helicobacter pylori* ; Helicobacter* ; Humans ; Medical Records ; Metronidazole ; Probiotics* ; Research Personnel

Collagenous colitis is an uncommon condition charaeterized clinically by diarrhea and weight loss and histologically by thickening of the subepithelial collagen band with chromic inflammation. Laboratory tests of blood, urine and stool, and colonscopic findings are usually normal. The etiology of collagenous colitis is unknown. We report a case of collagenous colitis improved after treatment with sulfasalazine with review of literatures.
Colitis, Collagenous* ; Collagen* ; Diarrhea ; Inflammation ; Sulfasalazine ; Weight Loss

OBJECTIVE: This study examined the potential of the in vitro osteogenesis of microtopographically modified surfaces, RBM (resorbable blasting media) surfaces, which generate hydroxyapatite grit-blasting. METHODS: RBM surfaces were modified hydroxyapatite grit-blasting to produce microtopographically modified surfaces and the surface morphology, roughness or elements were examined. To investigate the potential of the in vitro osteogenesis, the osteoblastic cell adhesion, proliferation, and differentiation were examined using the human osteoblast-like cell line, MG-63 cells. Osteoblastic cell proliferation was examined as a function of time. In addition, osteoblastic cell differentiation was verified using four different methods of an ALP activity assay, a mineralization assay using alizarin red-s staining, and gene expression of osteoblastic differentiation marker using RT-PCR or ELISA. RESULTS: Osteoblastic cell adhesion, proliferation and ALP activity was elevated on the RBM surfaces compared to the machined group. The cells exhibited a high level of gene expression of the osteoblastic differentiation makers (osteonectin, type I collagen, Runx-2, osterix). imilar data was represented in the ELISA produced similar results in that the RBM surface increased the level of osteocalcin, osteopontin, TGF-beta1 and PGE2 secretion, which was known to stimulate the osteogenesis. Moreover, alizarin red-s staining revealed significantly more mineralized nodules on the RBM surfaces than the machined discs. CONCLUSION: RBM surfaces modified with hydroxyapatite grit-blasting stimulate the in vitro osteogenesis of MG-63 cells and may accelerate bone formation and increase bone-implant contact.
Anthraquinones ; Cell Adhesion ; Cell Differentiation ; Cell Line ; Cell Proliferation ; Collagen Type I ; Dinoprostone ; Durapatite ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Humans ; Osseointegration ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Osteopontin ; Transforming Growth Factor beta1

OBJECTIVE: To examine the mechanism for the inhibited differentiation of osteoclasts in rheumatoid arthritis synovial CD14+ osteoclast precursors, the different expressions of the osteoclastogenesis-related genes in rheumatoid arthritis (RA) synovial fluid CD14+ osteoclast precursors were compared with those of normal peripheral blood (PB) CD14+ osteoclast precursors. METHODS: The expression of osteoclastogenesis-related genes were examined using a gene expression oligonucleotide microarray. To validate the results of the microarray analysis, the mRNA expressions of osteoclastogenesis-related genes were measured by real-time PCR. RESULTS: Comparative analysis of the mRNA profiles showed significantly different expression of osteoclastogenesis- related genes, such as MafB, Id3 and LILRB4, in the RA synovial CD14+ osteoclast precursors, compared to that of normal PB CD14+ osteoclast precursors. CONCLUSION: The expression of the osteoclastogenesis-related genes in RA synovial CD14+ osteoclast precursors is different from that of the normal PB CD14+ osteoclast precursors. These results suggest that the different expression of osteoclastogenesis-related genes might be involved in the altered osteoclastogenesis in RA synovial osteoclast precursors.
Arthritis, Rheumatoid ; Genes, vif ; Macrophages ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis ; Osteoclasts ; RNA, Messenger ; Synovial Fluid

The aim of this study was to investigate the expression and localization of cyclooxygenase-1 and -2 (COX-1 and COX-2) in synovial tissues from patients with rheumatoid arthritis (RA). Synovial tissues from 9 patients with RA and 5 patients with osteoarthritis (OA) were examined for COX-1 and COX-2 expressions by immunohistochemical staining using 2 polydonal COX-1 and COX-2 antibodies. In RA synovia, synovial lining cells showed intense immunostaining for COX-1, whereas slight to moderate staining was observed in inflammatory cells, stromal fibroblast-like cells and vascular endothelial cells. There was no significant difference in COX-1 expression between RA and OA synovia. The localization of COX-2 expression dearly differed from that of COX-1 expression, being most intense in inflammatory cells. However, there was no difference in COX-1 and COX-2 expressions between RA and OA synovial tissues. Our observations support that inflammatory mechanisms modulated by COX-1 and COX-2 in chronic RA synovium might be similar to those in chronic OA synovium.
Adult ; Aged ; Arthritis, Rheumatoid/pathology ; Arthritis, Rheumatoid/enzymology* ; Cell Division ; Female ; Fibrin/metabolism ; Human ; Isoenzymes/metabolism ; Isoenzymes/biosynthesis* ; Male ; Middle Age ; Neutrophil Infiltration ; Osteoarthritis/enzymology ; Prostaglandin-Endoperoxide Synthase/metabolism ; Prostaglandin-Endoperoxide Synthase/biosynthesis* ; Stromal Cells/pathology ; Stromal Cells/enzymology ; Synovial Membrane/pathology ; Synovial Membrane/enzymology*

No abstract available.
Arthritis, Rheumatoid* ; Cyclooxygenase 1* ; Cyclooxygenase 2 ; Humans ; Osteoarthritis

Benign primary headaches are common during the postpartum period. However, there are several other kinds of headaches caused by specific underlying pathologies like post-dural puncture headache (PDPH), pregnancy induced hypertension, cortical vein thrombosis, posterior reversible encephalopathy syndrome (PRES), subarachnoid hemorrhage, intracranial hemorrhage, brain tumor, and so on. These headaches are rare but each can be life threatening conditions when diagnosis is delayed. If a patient was treated for another type of headache, like a PDPH, the diagnosis would be even more difficult. We report on the case of a 24 year-old woman who suffered with PDPH followed by postpartum eclampsia with PRES.
Diagnosis ; Eclampsia ; Female ; Headache ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Intracranial Hemorrhages ; Pathology ; Post-Dural Puncture Headache ; Posterior Leukoencephalopathy Syndrome* ; Postpartum Period ; Pregnancy ; Seizures ; Subarachnoid Hemorrhage ; Thrombosis ; Veins