The intramedullary nailing is one of the most available method in the treatment of femoral shaft fracture. Since the development of Küntscher nail in 1940, new designs such as the Grosse-Kempf interlocking femoral nail, Ressell-Taylor Femoral nial, AO/ASIF universal nail, ACE titanium nail became widely used by more applicable level of femoral shaft fracture. But complication of intramedullary nailing was rarely seen. The authors analyzed the clinical and mechanical factors predisposing to failures of intramedullary interlocking nails in 6 cases whom treated the comminuted fracture of the femoral shaft, at the department of orthopaedic surgery, Sun General Hospital from 1991 to 1995 and the following results are obtained. 1. Initial fracture patterns were comminuted in all 6 cases. 2. The implant nails were AO nail in 4 cases, Grosse-Kempf nail in 1 case, Russell-Taylor nail in 1 case(nail diameter was 10mm to 12mm). 3. The failure sites of the interlocking nail were the initial bone fracture site in 2 cases, distal to the proximal screw hole in 1 case, proximal to the distal screw hole in 2 cases, fracture site and distal to the proximal screw hole in 1 case. 4. The average time to failure of implants were 11.5 months. 5. The average times to partical weight bearing were 6.3 weeks. In the analy of above results, by using diameter of nail more than 13mm and delaying weight bearing on the injured limb until there is clear radiographic evidence of early union of the femur fracture, we may reduce the metal failures of intramedullary interlocking nail in comminuted femoral shaft fractures.
Extremities ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Comminuted ; Hospitals, General ; Methods ; Solar System ; Titanium ; Weight-Bearing

PURPOSE: To evaluate the effect of portal hypertension on the tumor recurrence in patients with hepatocellular carcinoma (HCC) and without hepatic decompression following radiofrequency ablation (RFA). MATERIALS AND METHODS: Treatment-naïve HCC patients within the Milan criteria and with Child-Pugh class A were included in this study, who had performed RFA in our hospital between January 2010 and March 2017. Univariate and multivariate analyses using the Cox proportional hazard model were performed to find the predictors of local or distant tumor recurrence. RESULTS: Overall, 178 patients were included in this study. Median follow-up period was 40.2 months. The difference in the local tumor progression rates depending on the absence or presence of portal hypertension was not statistically significant (p = 0.195). The 1-, 3-, and 5-year distant intrahepatic tumor spread rates were 6.6%, 29.5%, and 537% in patients without portal hypertension, and 23.4%, 51.9%, and 63.6% in patients with portal hypertension, respectively. The difference was statistically significant (p = 0.011). Univariate and multivariate analysis showed that portal hypertension was an independent predictor for distant intrahepatic tumor spread (p = 0.008). CONCLUSION For HCC patients with Child-Pugh class A, portal hypertension adversely affected distant intrahepatic tumor progression.

In rat hippocampus, kainic acid (KA; 10 mg/kg; i.p.) increased the phosphorylated forms of ERK1/2 (p-ERK1/2) and Jun kinase1 (p-JNK1), but not p-JNK2 and p38 (p-p38). The preadministration with cycloheximide (CHX; 5 mg/kg; i.p.) inhibited KA-induced increase of p-JNK1, but not p-ERK1/2. Surprisingly, the phosphorylated upstream MAP kinase kinases (p-MKKs) were not correlated with their downstream MAP kinases. The basal p-MKK1/2 levels were completely abolished by KA, which were reversed by CHX. In addition, p-MKK4 and p-MKK3/6 levels were enhanced by CHX alone, but were attenuated by KA. Thus, our results showed that KA increased the p-ERK and p-JNK levels in rat hippocampus, which were not parallel with their classical upstreamal kinases.
Animals ; Cycloheximide ; Hippocampus* ; Kainic Acid* ; Mitogen-Activated Protein Kinase Kinases ; Mitogen-Activated Protein Kinases* ; Phosphorylation* ; Phosphotransferases ; Rats*

OBJECTIVE: The intracranial pathologies after head trauma should be usually progressed. It is clearly visualized in the non-invasive brain CT. The invasive monitor such as intracranial pressure (ICP) monitoring may be accompanied with the complications. This study aims whether the patients with severe head injury could be managed with serial CT scans. METHODS: The medical records of 113 patients with severe head injury in the prospectively enrolled trauma bank were retrospectively analyzed. After the emergency care, all the patients were admitted to the intensive care unit for the aggressive medical managements. Repeat brain CT scans were routinely taken at 6 hours and 48 hours after the trauma. ICP monitoring was restrictively applied for the uncertain intracranial pressure based on the CT. The surgical intervention and the mortality rate were analyzed. RESULTS: Immediate surgical intervention after the initial CT scan was done in 47 patients. Among the initially non-surgical patients, 59 patients were managed with the serial CT scans and 7 with the ICP monitoring. Surgical interventions underwent eventually for 10 patients in the initially non-surgical patients; 1 in the ICP monitoring and 9 in the serial CT. The mortality rate was 23.7% in the serial brain CT and 28.6% in the ICP monitoring. There was no statistical difference between two groups in the aspect of mortality (p=0.33). CONCLUSION: Serial CT scans in time could be a good way to monitor the intracranial progression in the severe head injury and reduce the implantation of an invasive ICP probe.
Brain* ; Craniocerebral Trauma* ; Emergency Medical Services ; Humans ; Intensive Care Units ; Intracranial Pressure* ; Medical Records ; Mortality ; Pathology ; Prospective Studies ; Retrospective Studies ; Tomography, X-Ray Computed*

Runx2 and Osterix, the transcription factors for osteoblast differentiation, are known as fundamental factors to regulate the development of calcified tissues. However, the biological functions of these factors in the development of the periodontal tissues remain unclear. In this study, we investigated the distribution of Runx2 and Osterix during periodontal tissue development of the mice. Mandibles from 14-day-old mice were prepared for paraffin section. Serial sections of the mandible containing 1st molar tooth germs were obtained as a thickness of 7 microm. Some sections were stained with hematoxylin and eosin. Others were used for immunohistochemistry for PCNA, Runx2, and Osterix. Epithelial cells in growing end of Hertwig's epithelial root sheath (HERS) and mesenchymal cells adjacent to the growing end of HERS expressed PCNA. Undifferentiated mesenchymal cells and hard tissue forming cells like cementoblasts and osteoblasts in early stage of differentiation expressed Runx2. Fully differentiated cementoblasts and osteoblasts secreting matrix proteins expressed Osterix. However, the cells terminated the matrix formation did not express Osterix. Periodontal ligament cells expressed Runx2 and Osterix. Pulp cells expressed Runx2 only.These results suggest that Runx2 and Osterix might regulate the differentiation of cementoblasts in the same manner as osteoblasts. Runx2 might participate in the process of cementoblast differentiation in early stage, whether Osterix might regulate the maturation and matrix synthesis of the cells.
Animals ; Dental Cementum ; Eosine Yellowish-(YS) ; Epithelial Cells ; Hematoxylin ; Immunohistochemistry ; Mandible ; Mice ; Molar ; Osteoblasts ; Paraffin ; Periodontal Ligament ; Proliferating Cell Nuclear Antigen ; Proteins ; Tooth Germ ; Transcription Factors

No abstract available.
Caroli Disease*

Our previous principal component analysis conducting on reference points, lines and angles, and a vectordeveloped polar coordinate system has elucidated that the components of eigenvectors had positive relationships in the curvature of anterior teeth segment, between the protrusion of canines and degree of arch roundness, and in the length-to-width ratio of 62 maxillary dentitions, which were preliminarily classified with reference to the conventional Thompson's morphological descriptions for dental arch forms. In the present study on morphological characters of the maxillary dentitions, we conducted a Fourier analysis on the previously obtained data. We observed that the amplitude of 2nd, 3rd and 4th Fourier harmonics were closely correlated with the length-to-width ratio, curvature of the anterior teeth segment, and the curvilinear contour of maxillary dental arches. In addition, the relationships between previously estimated data and the constant value and the amplitude of the Fourier series were examined by analysis of correlation coefficients (p<0.01). The results of the present study suggest that the morphology of maxillary dentitions consists of three essentials-the length-to-width ratio, the curvature of anterior teeth and the curvilinear contour of dental arches.
Dental Arch ; Dentition ; Fourier Analysis ; Principal Component Analysis ; Tooth

No abstract available.
Glaucoma* ; Humans ; Nerve Fibers* ; Photography* ; Retinaldehyde*

PURPOSE: To assess the accuracy of intraocular lens (IOL) power predictions for cataract surgery in eyes with primary angle-closure glaucoma (ACG). Because of shifting of the capsular bag apparatus and shortening of the axial length, preoperative calculation of IOL power may be inaccurate for eyes with ACG. MATERIALS AND METHODS: This retrospective comparative case series comprised of 42 eyes from 42 patients with primary ACG and 45 eyes from 45 subjects with normal open-angles undergoing uneventful cataract surgery. Anterior segment biometry including anterior chamber depth, lens thickness, and axial length were compared. Using the SRK-II formula, the powers of the implanted IOL and the actual postoperative spherical equivalent (SE) refractive errors were compared between the two groups. Also, the absolute values of differences between predicted and residual SE refractive errors were also analyzed for each group. RESULTS: In ACG patients, anterior chamber depth and axial length were shorter and the lens was thicker than normal controls (all p < 0.001). Even though residual SE refractive error was not significantly different (p = 0.290), the absolute value of the difference between predicted and residual SE refractive error was 0.64 +/- 0.50 diopters in AGC patients and 0.39 +/- 0.36 diopters in control subjects (p = 0.012). The number of eyes that resulted in inaccurate IOL power predictions of more than 0.5 diopters were 21 (50.00%) in the ACG group, but only 12 (26.67%) in the control group (p = 0.043). CONCLUSION: IOL power predictions for cataract surgery in ACG patients can be inaccurate, and it may be associated with their unique anterior segment anatomy.
Biometry ; *Cataract Extraction ; Eye/anatomy & histology/pathology ; *Glaucoma, Angle-Closure ; *Lens Implantation, Intraocular ; Retrospective Studies