Buckwheat is known as a health food but is one of the major food allergens triggering potentially fatal anaphylaxis in Asia, especially in Japan and Korea. This study was conducted to investigate the characteristic of enzymatic resistance of buckwheat protein and allergenic potential. Enzymatic resistance of buckwheat protein was performed with in vitro digestibility test in simulated gastric fluid (SGF), pH 1.2, using pepsin and simulated intestinal fluid (SIF) using chymotrypsin. Reactivity of buckwheat proteins to human IgE was performed using six allergic patients sensitized to buckwheat. Buckwheat's IgE levels were measured using the Phadia UniCAP-system. Buckwheat protein, 16 kDa, still remained after 30 min treatment of pepsin on SDS-PAGE. Even though 16 kDa almost disappeared after 60 min treatment, two out of the six buckwheat patients' sera showed reactivity to hydrolysate after 60 min treatment, indicating that allergenicity still remained. In simulated intestinal fluid (SIF) using chymotrypsin, buckwheat protein, 24 kDa, showed resistance to hydrolysis with chymotrypsin on SDS-PAGE, and still had allergenicity based on the result of ELISA. Our results suggest that buckwheat proteins have strong resistance to enzyme degradation. This may be attributed in part to the allergenic potential of buckwheat. Further study should be continued regarding buckwheat allergy.
Allergens ; Anaphylaxis ; Asia ; Chymotrypsin ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Fagopyrum ; Food, Organic ; Humans ; Hydrogen-Ion Concentration ; Hydrolysis ; Hypersensitivity ; Immunoglobulin E ; Japan ; Korea ; Pepsin A ; Proteins

BACKGROUND/OBJECTIVES: Due to its beneficial health effects, use of buckwheat has shown a continuous increase, and concerns regarding the allergic property of buckwheat have also increased. This study was conducted for evaluation of the hydrolytic effects of seven commercial proteases on buckwheat allergens and its allergenicity. MATERIALS/METHODS: Extracted buckwheat protein was hydrolyzed by seven proteolytic enzymes at individual optimum temperature and pH for four hours. Analysis was then performed using SDS-PAGE, immunoblotting, and competitive inhibition ELISA (ciELISA) with rabbit antiserum to buckwheat protein, and direct ELISA with pooled serum of 21 buckwheat-sensitive patients. RESULTS: Alkaline protease, classified as serine peptidase, was most effective in reducing allergenicity of buckwheat protein. It caused decomposition of the whole buckwheat protein, as shown on SDS-PAGE, and results of immunoblotting showed that the rabbit antiserum to buckwheat protein no longer recognized it as an antigen. Allergenicity showed a decrease of more than 50% when pooled serum of patients was used in ELISA. Two proteolytic enzymes from Aspergillus sp. could not hydrolyze buckwheat allergens effectively, and the allergenicity even appeared to increase. CONCLUSIONS: Serine-type peptidases appeared to show a relatively effective reduction of buckwheat allergenicity. However, the antigenicity measured using rabbit antiserum did not correspond to the allergenicity measured using sera from human patients. Production of less allergenic buckwheat protein may be possible using enzymatic hydrolysis.
Allergens ; Aspergillus ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Fagopyrum* ; Humans ; Hydrogen-Ion Concentration ; Hydrolysis* ; Hypersensitivity ; Immunoblotting ; Peptide Hydrolases ; Serine

PURPOSE: This study prospectively evaluated the outcome of arthroscopic transtendinous repair as a treatment for partial articular side tears of the rotator cuff. MATERIALS AND METHODS: Fifteen patients with symptomatic, partial articular side tears of the rotator cuff underwent modified transtendinous repair. The patient's mean age was 52.5 years and the mean duration of symptoms was 33.7 weeks. The visual analogue scale (VAS), the ASES score, the active ROM of the shoulder and the patient's satisfaction were evaluated both preoperatively and postoperatively. The clinical results were analyzed using the Wilcoxon's signed rank test. RESULTS: The mean VAS was 6.6+/-1.1 before treatment and 0.4+/-0.6 at 6 month, and the ASES scores for all the patients were significantly better over the six-month period of follow-up (p<0.05). The mean active ROM in abduction was 94.3+/-22.3 before treatment, 108.7+/-16.3 at 1 month (p=0.0041) and 164.3+/-5.3 at six months (p=0.0006). In flexion, it was 105.0+/-23.8 before treatment, 119.0+/-17.4 at 1 month (p=0.0075) and 174.3+/-5.3 at six months (p=0.0006). At the final follow-up, 94% of patients were satisfied or very satisfied after operation. CONCLUSION: We experienced satisfactory clinical results after a short-term follow-up of arthroscopic transtendinous repair, and we believed this to be an effective procedure for patients with partial articular side tears of the rotator cuff.
Arthroscopy ; Follow-Up Studies ; Humans ; Prospective Studies ; Rotator Cuff ; Shoulder

We made a mistake in presenting author affiliations.

BACKGROUNDS: Katz index of ADL and Barthel index of ADL have been used to evaluate the function of disabled elderly in Korea. But no ADL scale reflecting Korean's own language expression and culture has been developed and verified yet. METHODS: Descriptions of basic activities which needed others' help were collected from 190 Korean disabled elderly. The collected results were categorized into basic activities of daily living and instrumental activities of daily living, and then in each domain such as bathing, shopping, etc. Preliminary instrument items were selected by the judgement of the expert committee, considering the frequency of the responses and the importance of each item. A preliminary questionnaire was developed based on the selected items. The preliminary questionnaire was pretested twice, and corrected by the results. Finally a scholar on Korean literature verified the questionnaire on the grammar and context. RESULTS: A total of 408 basic activities of daily living and 242 instrumental activities of daily living were collected. The activities were categorized into 7 domains of ADL(dressing, washing face and hand, bathing, eating, transfer, toileting, continence) and 10 domains of IADL(decorating, housework, preparing meals, laundry, outgoing for a short distance, using transportation, shopping, handling money, using telephone, taking medicine) CONCLUSIONS: We developed a Korean Activities of Daily Living(K-ADL) scale and Korean Instrumental Activities of Daily Living(K-IADL) scale reflecting Korean elderly's own language expression and culture.
Activities of Daily Living ; Aged ; Baths ; Eating ; Hand ; Housekeeping ; Humans ; Korea ; Meals ; Surveys and Questionnaires ; Telephone ; Transportation

PURPOSE: The purpose of this study is to evaluate the radiologic findings of the extraosseous Ewing's sarcoma. MATERIALS AND METHODS: Six patients with pathologically confirmed extraosseous Ewing's sarcoma were retrospectively reviewed. Patients included two men and four women with an average age of 21.5 years (age range 9-48 years). Plain radiographs (six patients), magnetic resonance (MR) images (five patients), computed tomographic (CT) scans (three patients) and whole body scintigraphy (two patients) were reviewed and analyzed. Images were evaluated with regard to lesion location, size, margin, muscle or bone involvement and intrinsic imaging characteristics on CT and MRI. RESULTS:The tumors were located in the thigh (three patients), back (two patients) and upper arm (one patient). The tumors ranged in size from 2.3 cm to 7.5 cm (mean, 5.2 cm), were mainly well circumscribed and showed no evidence of calcification prior to treatment. Margins were well defined in four out of the six patients. Four patients had subcutaneous lesions and the other two patients had intramuscular lesions. Muscle (two patients) and bone invasion (one patient) were present. The masses were heterogenous low signal intensity on T1 weighted images and heterogeneous high signal intensity on T2 weighted images compared with muscle. Heterogeneous enhancement within the lesion was observed in all patients on CT and MRI. Whole body scintigraphy using Tc-99 m MIBI showed increased uptake in the masses of two patients. CONCLUSION: Extraosseous Ewing's sarcomas were frequently seen as a well-circumscribed ovoid mass with nonspecific findings on CT and MRI. Despite being a relative rare tumor, it should be included in the differential diagnosis of a non-calcified soft-tissue mass, especially in subcutaneous tissue.
Arm ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Radionuclide Imaging ; Retrospective Studies ; Sarcoma, Ewing* ; Subcutaneous Tissue ; Thigh

Acromioclavicular joint injuries usually occur as a result of direct trauma to the superolateral aspect of the shoulder. Roockwood Type IV injuries are relatively uncommon, and they are easily misdiagnosed or neglected in patients who have suffered multiple traumas. Therefore, to correctly treat a patient with type IV injury, we need to take a careful physical examination and conduct proper radiologic evaluation for the acromioclavicular joint. We report here on two cases of modified Weaver-Dunn reconstruction for neglected type IV acromioclavicular joint injuries that were associated with multiple rib fractures.
Acromioclavicular Joint ; Humans ; Joints ; Multiple Trauma ; Physical Examination ; Ribs ; Shoulder

PURPOSE: To evaluate and compare the spontaneous regeneration repair process in femoral bone defects in 6-week-old rabbits and to compare the healing time periods between different rabbit groups. MATERIALS AND METHODS: Bone defects were created at the femur mid-shaft and an external fixator was applied in 50 rabbits. The periosteum was resected in 10 rabbits (defect size: 15%, 25%) and left untouched in the remaining rabbits. Forty rabbits were divided into four groups according to the percentage of bone defects (15%, 20%, 25%, 30%). Radiographs were taken weekly to evaluate the bone regeneration and union. The bone union time was measured between the osteotomy and the cortico-medullary differentiation by examining radiographs. The healing index was defined as the union time (week) per amount (cm) of bone defect. Eight rabbits, 2 from each groups with the bone defects, were investigated by histopathologic examination. RESULTS: The mean union time was approximately 7.0 to 7.3 weeks. The healing index in groups that had a large percentage of bone defects was less than in groups that had a small percentage of bone defects. The periosteum-resected group did not show bone regeneration. Histopathologic examinations showed intramembranous and atypical endochondral ossifications along the periosteum and typical endochondral ossification at the center of the bone defects. CONCLUSION: Spontaneous bone regeneration may be used in children to fill the bone defect instead of performing an internal bone transport. Spontaneous bone regeneration is useful in cases of mid-shaft bone defects or when the remaining bone fragments are large enough for an external fixation application.
Bone Regeneration* ; Child ; External Fixators ; Femur ; Humans ; Osteotomy ; Periosteum ; Rabbits* ; Regeneration

PURPOSE: To assess the effectiveness of a prosthetic replacement of the humeral head in rotator cuff tear arthropathy patients. MATERIALS AND METHODS: 11 patients underwent a prosthetic replacement of the humeral head for rotator cuff tear arthropathy between 1997 and 2003. The average age was 69 years and 9 out of the 11 patients were women. The average follow-up was 44 months. The level of pain, daily activities, range of motion and patient's satisfaction were assessed both preoperatively and postoperatively. RESULTS: The mean pain score decreased from 9.0 preoperatively to 2.2 postoperatively. The mean active forward elevation increased from 40o to 82o and the mean external rotation increased from 8.2o to 30o. The mean ASES score improved from 22 to 72. Nine patients were satisfied with the surgical outcome, particularly in terms of pain relief and the improvement in their daily activities. CONCLUSION: A prosthetic replacement of the humeral head is an effective treatment option for pain relief as well as for improving the functional activity in rotator cuff tear arthropathy.
Female ; Follow-Up Studies ; Humans ; Humeral Head* ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder

PURPOSE: This study compared the results of external fixation with those of flexible intramedullary nailing using Ender nails in pediatric femoral shaft fractures. MATERIALS AND METHODS: Twenty-eight children with pediatric femoral shaft fractures were enrolled in the study. The children's ages ranged from 6 to 11 years, and the average period of follow-up was 27.2 months. Fifteen patients underwent flexible intramedullary nailing (FIN) using Ender nails and thirteen patients underwent external fixation (EF). The outcomes were assessed based on the clinical and radiology findings. RESULTS: The healing time averaged 9.8 weeks in the FIN group and 11.2 weeks in the EF group. In the FIN group, one patient suffered pin migration. In the EF group, three patients had a pin site infection, one patient had refracture after removing the external fixator and one patient had pin breakage 8 weeks after surgery. The broken pin was removed and the condition was stabilized with internal fixation using a plate. CONCLUSION: Flexible intramedullary nailing with Ender nails is an effective treatment option for treating femoral shaft fractures in children because it has fewer complications than external fixation does.
Child ; External Fixators ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Nails