No abstract available.
Animals ; Heart* ; Rats* ; Wisconsin*

BACKGROUND: The purpose of this study was to evaluate the clinical and radiographic outcomes of internal fixation with locking T-plates for osteoporotic fractures of the proximal humerus in patients aged 65 years and older. METHODS: From January 2007 through to December 2015, we recruited 47 patients aged 65 years and older with osteoporotic fractures of the proximal humerus. All fractures had been treated using open reduction and internal fixation with a locking T-plate. We classified the fractures in accordance to the Neer classification system; At the final follow-up, the indicators of clinical outcome-the range of motion of the shoulder (flexion, internal rotation, and external rotation) and the presence of postoperative complications-and the indicators of radiographic outcome-the time-to-union and the neck-shaft angle of the proximal humerus-were evaluated. The Paavolainen method was used to grade the level of radiological outcome in the patients. RESULTS: The mean flexion was 155.0° (range, 90°–180°), the mean internal rotation was T8 (range, T6–L2), and the mean external rotation was 66.8° (range, 30°–80°). Postoperative complications, such as plate impingement, screw loosening, and varus malunion were observed in five patient. We found that all patients achieved bone union, and the mean time-to-union was 13.5 weeks of the treatment. The mean neck-shaft angle was 131.4° at the 6-month follow-up. According to the Paavolainen method, “good” and “fair” radiographic results each accounted for 38 and 9 of the total patients, respectively. CONCLUSIONS: We concluded that locking T-plate fixation leads to satisfactory clinical and radiological outcomes in elderly patients with proximal humeral fractures by providing a larger surface area of contact with the fracture and a more rigid fixation.
Aged ; Classification ; Follow-Up Studies ; Humans ; Humerus ; Methods ; Osteoporotic Fractures ; Postoperative Complications ; Range of Motion, Articular ; Shoulder ; Shoulder Fractures*

The size and configuration of the lumbar spinal canal constitute one of the important factors in the production of symptoms referable to cauda equina and nerve roots of the lumbar spine and the narrowness of the spinal canal. Numerous attempts have been made to measure the size of the lumbar spinal canal, but most of those are not sufficient to measure the oblique diameter of the lumbar spinal canal. Also, echographic diagnosis is much simple, safe, less expensive and non-invasive and furthermore demonstrates much more accuracy than other alternative and radiographic procedures. The purpose of this study is to establish the range of normal values of the oblique diameter of the lumbar spinal canal in Korean Army-aged group by echographic method in the interest of facilitating clinical evaluation of the lumbar spinal canal stenosis. The author measured oblique diamenter of the lumbar spinal canal in thirty healthy persons of both sexes of ages between nineteen and twenty-five years by ultrasound using sonolayergraphy model SSL-21A. Distance from the ligamentum flavum to the posterior longitudinal ligament was measured in millimeters with dial vernier caliper. Actual distance of oblique diameter of the lumbar spinal canal is obtained by multiplication of the distance of echogram by calibration factor 2.22. The results were as follows; 1. The mean values of the oblique diameter of the lumbar spinal canal in male and female between nineteen and twenty-five years of age were 14.77±0.85mm and 14.87±0.82mm in Ll, 13.99±0.87mm and 14.13±0.96mm in L2, 13.40±0.69mm and 13.71±0.75mm in L3, 12.88±0.69mm and 12.93±0.68mm in L4, 14.58±0.79mm and 14.42±0.84mm in L5 respectively. 2. The oblique diameter of the lumbar spinal canal was the widest at the first lumbar vertebra, the next at the fifth lumbar vertebra and the narrowest at the fourth lumbar vertebra. 3. There was no difference of diameter of the lumbar spinal canal between both sexes.
Calibration ; Cauda Equina ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Ligamentum Flavum ; Longitudinal Ligaments ; Male ; Methods ; Reference Values ; Spinal Canal ; Spine ; Ultrasonography

No abstract available.
Occupational Diseases*

PURPOSE: The purpose of this study was to describe the anglographic finding and clinical result of transarterial embolotherapy(TAE) in patients with injuries of renal artery branches by blunt trauma. MATERIALS AND METHODS: The study was based on retrospective analysis of seven cases, in which TAE was attempted for the control of traumatic renal arterial bleeding. All procedures were performed via the transfemoral approach. TAE was performed with stainless steel coil in two cases, Gelfoam in one case, and Gelfoam and stainless steel coil in four cases. RESULTS: Angiographic findings of vascular injuries were pseudoaneurysm in four cases, extravasation in two cases and arteriocalyceal fistula in one case. All procedures were performed successfully without complication. CONCLUSION: Pseudoaneurysm is a common anglographic finding in patients with injury of renal artery branches and TAE is considered a safe and effective method for treating such cases.
Aneurysm, False ; Embolization, Therapeutic* ; Fistula ; Gelatin Sponge, Absorbable ; Hemorrhage ; Humans ; Renal Artery* ; Retrospective Studies ; Stainless Steel ; Vascular System Injuries

Pediatric caudal anesthesia appears to be a safe and reliable technique for surgical procedures below the umbilicus. Advantages of caudal anesthesia in infants and children include the simplicity of the technique, the high success rate, the post operative pain relief and the rare complication rate. The aim of this study was to determine an ideal local anesthetic agent and its dosage for clinical practice in pediatric caudal anesthesia. Caudal anesthesia was given to 97 patients who were divided into three groups. Group I was given 1% lidocaine l ml/kg, Group 2 was given 1% lidocaine 0.7 ml/kg and Group 3 was given 0.25% bupivacaine 1 ml/kg. All caudal blocks were carried out in the left lateral position after thiopental 4-5 mg/kg iv or under general anesthesia with halothane. The duration of anesthesia, the side effects during and after operation, the post operative pain score, motor activity, and sensory level were observed and compared among the three groups. As the result of this study, we think that caudal anesthesia using 1% lidocaine and 0.25% bupivacaine is a safe, simple and practical method in clinical practice for infants and children. The duration of anesthesia ranged from 60 to 120 minutes, and side effects were rare and insignificant. The patients position for caudal blocks was most suitable in the left lateral position. We came to the conclusion that the use of 1% lidocaine 1 ml/kg is most practical in safe practice of pediatric caudal anesthesia and 1% lidocaine 0.7 ml/kg and 0.25% bupivacaine l ml/ kg can be recommended depending on the surgical locations and required time for surgical procedures.
Anesthesia ; Anesthesia, Caudal* ; Anesthesia, General ; Bupivacaine* ; Child ; Halothane ; Humans ; Infant ; Lidocaine ; Motor Activity ; Thiopental ; Umbilicus

Present study aimed to investigate the immunological activities of cell wall associated protein antigen solubilized with Triton X-100 (TSP) from Mycobacterium tuberculosis H37Rv and conducted on 43 patients with pulmonary tuberculosis (newly diagnosed, medicated within 12 months and chronic refractory patients) and 17 normal healthy controls. These immunological responses were compared with those induced by the PPD or 30 kDa antigen from M, tuberculosis H37Rv culture filtrates, identified as biologically important secreted proteins. Proliferative responses to mycobacterial antigens were compared in peripheral blood mononuclear cells (PBMC) of healthy subjects and pulmonary tuberculosis patients. Signiticant blastogenic responses to the TSP were observed in healthy tuberculin reactors, newly diagnosed and some of antituberculosis drug-medicated patients by H-thymidine incorporation assay. IL-12 p40 and IFN-r mRNA expressions to the TSP were markedly increased, whereas IL-10 and TNF-a mRNA expressions were decreased at a 5 day-stimulation by PBMC in healthy tuberculin reactors, newly diagnosed and medicated patients. However, patients with chronic refractory tuberculosis exhibited more depressed IL-12 p40 and IFN-r mRNA expressions to all of the antigens than another groups. Interestingly, very low IL-10 and TNF-a mRNA expressions cultured with the TSP were also shown. These data suggest that the TSP may be involved in the macrophage activation by induction of Th1 stimulatory signals, such as IL-12, and suppression of Th1 inhibitory cytokine, IL-10.
Tumor Necrosis Factor-alpha

No abstract available.
Dimethylformamide* ; Liver Diseases* ; Liver*

BACKGROUND: This study examined hemodynamic variables, oxygen delivery, extraction, and consumption in response to acute progressive hypoxia and hypercarbia in the setting of apnea. METHODS: Apnea was induced in 9 healthy mongrel dogs by disconnecting animals from mechanical ventilation of 30 minutes with pure oxygen. Hemodynamic variables, oxygen transport, extraction, and consumption were rapidly and repeatedly measured using pulmonary arterial and arterial catheters until cardiac output was undetectable. RESULTS: The baseline PaO2, PaCO2, pH, base excess were 318 +/- 137 mm Hg, 36 +/- 3.5 mm Hg, 7.30 +/- 0.06, 6.81 +/- 2.65 mmol/l respectively. Hypercarbia and hypoxemia (76 +/- 33 mm Hg) was first noted at 1 and 4 minute respectively. Base excess was not changed. Indices of preload (PCWP and CVP) were increased early in the time course (p<0.05). In contrast, indices of afterload (SVR) increased later, just before cardiac decompensation began (p<0.05). No significant reduction of cardiac output, oxygen delivery, extraction, and consumption was detected just until abrupt cardiac decompensation started, 5 minute. CONCLUSIONS: These data suggest that the early increase in preload was primarily due to hypercarbia whereas the late increase in afterload was due to hypoxemia, but the main cause of acute cardiac decompensation was a critical decrease in arterial oxygen tension with some contribution of increased preload and afterload.
Animals ; Anoxia ; Apnea* ; Cardiac Output ; Catheters ; Dogs* ; Hemodynamics* ; Hydrogen-Ion Concentration ; Oxygen* ; Respiration, Artificial

Shy-Drager syndrome is a multisystem degenerative disorder of the central nervous system in which progressive autonomic failure such as orthostatic hypotension, urinary or fecal incontinence, impotence and anhidrosis is a main feature. The nonautonomic neurological abnormalities include parkinsonia, cerebellar and pyramidal signs. In 1984 we met 3 such cases at Seoul National University Hospital and present them here with a brief review of literatures.
Central Nervous System ; Erectile Dysfunction ; Fecal Incontinence ; Hypohidrosis ; Hypotension, Orthostatic ; Male ; Seoul ; Shy-Drager Syndrome*