A prospective study of vitamin B6, B12, folate, and homocysteine levels was carried out in 7 kidney transplant(KT) recipients. The first sample for the basal level was drawn on the morning of the KT day before the start of cyclosporine injection. Thereafter, serial blood samples were taken every day until the serum creatinine level decreased below 1.5 mg/dl and then every 2 or 3days until discharge. The serum creatinine level decreased to below 1.5 mg/dl within 3days except for cases 4 and 6. The homocysteine levels decreased markedly in synchronisation with serum creatinine levels increased during the first 7days and then declined together with serum creatinine levels but went up again after a few days. The levels of B6, and vitamin B12 do not continue to decrease after the levels of serum creatinine have decreased to 1.5mg/dl, while homocysteine levels go up progressively. In conclusion, contrary to our expectation, the level of homocysteine rebounds a few days after KT following a transient decline. A deficiency of folic acid, vitamin B6 and vitamin B12 does not seem to cause hyperhomocysteinemia in KT recipients. It is necessary to pay attention to hyperhomocysteinemia in KT recipients, especially when the recipients have an atherosclerosis-related complication.
Creatinine ; Cyclosporine ; Folic Acid ; Homocysteine* ; Hyperhomocysteinemia ; Kidney ; Kidney Transplantation* ; Plasma* ; Prospective Studies ; Vitamin B 12 ; Vitamin B 6

A survey of the literature on the treatment of ruptures of deltoid ligament associated with fracture of distal part of fibula is controversial. Some authors advocated surgical repair of the ruptured deltoid ligament based on the theoretical consideration, while others advocated non-operative treatment based on the clinical consideration. We studied the results in forty-five patients who were treated for disruption of the deltoid ligament and a distal fibular fracture. The length of follow-up in our series was twelve to twenty-four months, with an average of fifteen months. When the fibular fracture was adequately reduced and medial clear space was returned to its normal width, the 91 percents both of patients of being treated with repair of deltoid ligament and patients of being treated without repair had a good or excellent results.
Clinical Study ; Fibula ; Follow-Up Studies ; Humans ; Ligaments ; Rupture

Since sclerosing hemangioma of the lung was first described by Liebow and Hubbell in 1956, there have been several reports on cases occurring as a solitary nodule; however, sclerosing hemangiomas occurring as multiple nodules are extremely rare. The histogenesis of this tumor remains controversial and there are several hypotheses of the etiology. Three separate nodules were found in a 57-year-old housewife, one found in the right middle lobe, one in the apicoposterior segment of the left upper lobe, and one in the superior segment of the left lower lobe. The only symptom or sign presented was a dry cough. Apicoposterior segmentectomy of the left upper lobe and wedge resection of the superior segment of the left lower lobe were performed. The postoperative course was uneventful and the patient was discharged on the postoperative 15th day.
Cough ; Hemangioma ; Histiocytoma, Benign Fibrous* ; Humans ; Lung Neoplasms ; Lung* ; Mastectomy, Segmental ; Middle Aged ; Pulmonary Sclerosing Hemangioma

Seidel nail provides more advantages for treatment of humeral shaft fracture than other treatment modalities. It enables patients to get high bone union rate, makes surgical technigne less invasive, and allows early mobilization mobilization so that the patients is subjected to more comfortable treatment. But, Seidel nail is apt to injure the rotator cuff and has relatively weak holding power of distal fragment of fracture so that it may result in distraction and rotatory instability, and make nonunion and impaired shoulder function. Thus, in order to the functional and radiological results, complications and technical problems, we evaluated the efficacy of Seidel nail in treatment of 20 cases of hurneral shaft fractures from March l994 to March 1996, retrospectively. The results were as follows. 1. 18 cases(90%) achieved radiological union. 2. The time of union was 12.5 weeks in average. 3. 17 cases achieved satisfactory results according to Neers functional score. 4. The complications included proximal protrusion of nail from the entry site(10%), fracture of greater tuberosity of proximal humerus(5%), loosening of distal spreading screw(10%), and nonunion( l 0%). In conclusion, Seidel nailing is one of good treatment modalities for humeral shaft fracture, but skillful operative technique is needed to obtain the satisfactory functional result. And also, it is necessory to modify the distal locking system of Seidel nail to reinforce the rotational stahility of the fracture site.
Early Ambulation ; Humans ; Humerus ; Retrospective Studies ; Rotator Cuff ; Shoulder

PURPOSE: To determine the relation between clinical results and correction angle in proximal tibial osteotomy through the retrospective study. MATERIALS AND METHODS: Seventy-two valgus osteotomies of the tibia were performed in forty-nine patients from 1985 to 1992; average follow-up period was 7 year 11 months(range, 5 to 12 years). We classi- fied the patients into three groups according to the tibiofemoral angle measured at the last follow-up. Group I includes patients with less than valgus 6 degrees of tibiofemoral angle, Group II with from valgus 7 degrees to 9 degrees and Group III with more than valgus 10 degrees. RESULTS: The Insalls Hospital for Special Surgery knee score was gradually decreased in time as 95 at postoperative 2 years, 92 at 5 years and 82 at the last follow-up. The average preoperative tibiofemoral angle was varus 3.4 degrees and the average postoperative tibiofemoral angle was corrected as valgus 8.0 degrees, 7.9 degrees at two years, valgus 7.0 degrees at five years and valgus 5.4 degrees at the last follow-up. The group I, 40 cases(mean 9 year 7 month follow-up), showed postoperative valgus 6.4(3-15) degrees and val- gus 2.6 degrees at the last follow-up. Loss of correction was 3.8 degrees and knee score was 76 at the last fol- low-up. The group II, 21 cases(8 year 1 month), showed postoperative valgus 9.0(7-11) degrees and 7.6 degrees at the last follow-up. Loss of correction was 1.4 degrees and knee score was 83.5 at the last follow- up. The group III, 11 cases(7 year 7 month) showed postoperative valgus 11.4(10-15) degrees and 10.9 degrees at the last follow-up. Loss of correction was 0.5 degrees and knee score was 97 at the last follow-up. The group III showed better maintenance of postoperative correction angle and clinical results than the other gf OUpS. CONCLUSION: Deductively, it is essential to correct tibiofemoral angle more than 7, especially ranged from 10 to 15 degrees for the best long-term clinical results.
Follow-Up Studies ; Humans ; Knee ; Osteotomy* ; Retrospective Studies ; Tibia

A 62-year-old male was admitted for evaluation of a mass shadow on chest film. Chest PA showed 7×5cm lobulated homogenous mass in right upper medial area of lung. On chest computed tomography, there was a Barge irregularly lobulated mass with central necrotic low density area in apical segment of right upper lobe. Right upper lobectomy of the lung was performed. Partial adhesion to parietal pleura of posterior mediastinum and severe adhesion to right upper apicoposterior segment was found during the operation Microscopic and ultrastructural studies(including immunocytochemical stains) of the mass revealed malignant fibrous histiocytoma.
Coal* ; Histiocytoma, Malignant Fibrous* ; Humans ; Lung* ; Male ; Mediastinum ; Middle Aged ; Pleura ; Thorax

No abstract available.
Staphylococcus aureus* ; Staphylococcus*

Highly specific and sensitive immunoassay method for soluble human recombinant interleukin-6 (hu rlL-6) was established by two different immunization methods. One is conventional method by Freund's adjuvant method and the other is special method which is directly injected to mouse spleen. Among seven established monoclonal antibodies (mAbs), two typical monoclonal antibodies, designated YB3 (IgG1) and NY2 (IgM), were further characterized. These mAbs highly bound to IL-6, however did not show cross reactivity with IL-1B and IL-2. As the results of ELISA inhibition assay and western blotting method, it was further identified that YB3 and NY2 had high binding specificity with IL-6. And the limiting detection amount of rlL-6 for YB3 was 5 ng/ml and for NY2 was 0.5 ng/ml. Furthermore, N-glycosylated human rlL-6 was also bound to YB3 on ELISA. On the other hand YB-3 furtherly recognized N-glycosylated human rlL-6 by sandwich ELISA method. These mAbs may be of use to diagnose the gynecopathy which contains abortion and preterm labor.
Animals ; Antibodies, Monoclonal* ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Female ; Freund's Adjuvant ; Hand ; Humans ; Immunization ; Immunoassay ; Interleukin-2 ; Interleukin-6 ; Mice ; Obstetric Labor, Premature ; Pregnancy ; Sensitivity and Specificity ; Spleen

BACKGROUND: Hypothermia protects the brain by suppressing the cerebral metabolism and it is performed well enough before the total circulatory arrest(TCA) in the operation of aortic disease. Generally, TCA has been performed depending on the rectal or nasopharyngeal temperatures; however, there is no definite range of optimal temperature for TCA or an objective indicator determining the temperature for safe TCA. In this study, we tried to determine the optimal range of temperature for safe hypothermic circulatory arrest by using the intraoperative electroencephalogram(EEG), and studied the role of EEG as an indicator of optimal hypothermia. MATERIAL AND METHOD: Between March, 1999 and August 31, 2000, 27 patients underwent graft replacement of the part of thoracic aorta using hypothermia and TCA with intraoperative EEG. The rectal and nasopharyngeal temperatures were monitored continuously from the time of anesthetic induction and the EEG was recorded with a ten-channel portable electroencephalography from the time of anesthetic induction to electrocerebral silence(ECS). RESULT: On ECS, the rectal and nasopharyngeal temperatures were not consistent but variable(rectal 11degree C -25degree C, nasopharynx 7.7degree C -23degree C). The correlation between two temperatures was not significant(p=0.171). The cooling time from the start of cardiopulmonary bypass to ECS was also variable(25-127min), but correlated with the body surface area(p=0.027). CONCLUSION: We have found that ECS appeared at various body temperatures, and thus, the use of rectal or nasopharyngeal temperature were not useful in identifying ECS. Conclusively, we can not fully assure cerebral protection during hypothermic circulatory arrest in regards to the body temperatures, and therefore, the intraoperative EEG is one of the necessary methods for determining the range of optimal hypothermia for safe circulatory arrest.
Aorta, Thoracic ; Aortic Diseases ; Body Temperature ; Brain ; Cardiopulmonary Bypass ; Electroencephalography* ; Humans* ; Hypothermia ; Metabolism ; Nasopharynx ; Transplants

BACKGROUND: Transmyocardial revascularization (TMR) in end stage ischemic heart disease results in variable clinical responses. We investigated the acute effect of early reperfusion and the angiogenesis after formation of the transmyocardial channel in a transplanted rat heart model with acute myocardial infarction. MATERIAL AND METHOD: In the 30 transplanted hearts we induced acute myocardial infarction by ligating the proximal left coronary artery and inserted a porous 22G intravenous cannula into the left ventricle. After ten minutes of reperfusion, we removed the cannula. At every stage, we recorded the heart rate, QRS size, and left coronary arterial blood flow using the electrocardiogram and Doppler. One week later the rats were sacrificed and evaluated for the patency of intramyocardial channels and the angiogenesis. RESULT: The heart rates after ligation and after cannula insertion were 239.1+/-61.7, 235.8+/-58.0 bpm respectively, and they were statistically significantly slower than that of before ligation, 277.6+/-40.3 bpm (p=0.017, p=0.007 respectively). QRS sizes before ligation, after ligation, and after cannula insertion were 3.6+/-3.3 mm, 2.8+/-3.3 mm, and 2.4+/-2.2 mm, respectively, and there was no significant difference in the three groups. Doppler findings after ligation showed that average peak and mean values of coronary perfusion were significantly decreased from 2.11+/-0.17 kHz, 1.25+/-0.22 kHz to 0.83+/-0.15 kHz, 0.38+/-0.11 kHz (p<0.05 respectively). After insertion of the porous cannula, the average peak and mean values of coronary perfusion were 0.61+/-0.05 kHz and 0.33+/-0.05 kHz respectively, but there was no statistically significant change compared to values after ligation. In all cases except one, pathologic findings showed no patent channels in the acute stage, however, one case showed the angiogenesis. CONCLUSION: We confirmed that TMR in a rat heart transplant model did not show blood flow through the channel in the acute stage. However, reperfusion effect in some cases had a potential for angiogenesis.
Animals ; Catheters ; Coronary Vessels ; Electrocardiography ; Heart Rate ; Heart Ventricles ; Heart* ; Ligation ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Revascularization ; Perfusion* ; Rats* ; Reperfusion