Intercellular adhesion molecule-1(ICAM-1) is a cell-adhesion molecule that is constitutively expressed on human dermal microvascular endothelial cells and is inducible on human keratinocytes. We studied to compare the effects of Trichophyton antigen, glycerine, and recombinant IFN-gamma on the ICAM-1 expression on preimmune state keratinocytes. The 3x104 HaCaT cells/ml in 96 well microculture plates were cultured with Trichophyton antigen, glycerin, and IFN-gamma respectively. On culturing with Trichophyton antigen, ICAM-1 expression of HaCaT cells did not show significantly increased findings compared with control(P>0.05). On each group cultured with IFN-gamma and glycerin, ICAM-1 expression of HaCaT cells increased significantly compared with control(P<0.05). These results suggest that Trichophyton antigen does not sufficiently stimulate the expression of ICAM-1 of preimmune state keratinocytes without immunized T lymphocytes.
Endothelial Cells ; Glycerol ; Humans ; Intercellular Adhesion Molecule-1* ; Keratinocytes* ; T-Lymphocytes ; Trichophyton*

Purpose: To retrospectively compare the fixation methods for reattaching a trochanteric fragment in a pertrochanteric fracture treated with bipolar hemiarthroplasty. Materials and methods: Forty cases of an unstable femur pertrochanteric fracture were analyzed and followed up for average of 19(6~40) months. There were 18 cases fixed with tension band wiring (group 1), 7 cases treated using modified tension band wiring with K-wires (group 2) and 15 cases treated with the GTRD (Greater Trochanteric Reattachment Device) (group 3). Result: Group 1 was treated with simple a surgical procedure and the results were good. The second group had firm fixation postoperatively but required additional surgery in two cases to remove the K-wires because of wire migration after ambulation. Group 3 had relatively good results but required more dissection and a longer operating time. Conclusion: Tension band wiring or GTRD are good fixation methods for reattaching trochanteric fragments in pertrochanteric fractures. Moreover, tension band wiring is recommended for old osteoporotic patients due to a simple procedure and firm fixation. The use of modified tension band wiring using K-wire or a Steinmann-pin should not be used due to the possibility of distant migration.
Femur* ; Hemiarthroplasty* ; Humans ; Retrospective Studies ; Walking

Background: Although ginseng has beneficial effects largely related to their constituent ginsenosides, pharmacological effects of non-ginsenosides have been reported. Acidic polysaccharides of red ginseng (RGAP) are among the non-ginsenoside constituents that have characterized antioxidant properties. Objective: We investigated the impact of RGAP on sebocytes and outer root sheath (ORS) cells treated with lipopolysaccharide (LPS) and in mice with Cutibacterium acnes (C. acnes)-induced inflammatory nodules. Methods: Sebocytes and ORS cells were cultured and treated with either 0.1% dimethyl sulfoxide, 5 μg/ml LPS, 50 μg/ml RGAP or 5 μg/ml LPS+50 μg/ml RGAP for 6 and 24 hours.Real-time polymerase chain reaction, ELISA, Western blot analysis, and immunofluorescence staining were among the methods used to detect and quantify inflammatory cytokine production. Mice infected with C. acnes were treated with 2 weeks of RGAP provided in drinking water followed by immunohistochemical evaluation of inflammatory nodules. Results: Administration of RGAP to LPS-treated sebocytes and ORS cell cultures resulted in increased expression of inflammatory cytokines like interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-α, toll-like receptor 2, p-c-jun, p-JNK and p-iKB (p＜0.05). Administration of RGAP also resulted in increased expression of LL37 in LPS-treated sebocytes and ORS cells, and increased production of sebum in LPS-treated sebocytes (p＜0.05). RGAP also promoted increased expression of inflammatory biomarkers in C. acnes-associated inflammatory nodules in mice (p＜0.05). Conclusion RGAP may exacerbate inflammatory pathology associated with acne vulgaris. Ginseng supplements may be contraindicated in patients diagnosed with inflammatory acne.

Background: Although ginseng has beneficial effects largely related to their constituent ginsenosides, pharmacological effects of non-ginsenosides have been reported. Acidic polysaccharides of red ginseng (RGAP) are among the non-ginsenoside constituents that have characterized antioxidant properties. Objective: We investigated the impact of RGAP on sebocytes and outer root sheath (ORS) cells treated with lipopolysaccharide (LPS) and in mice with Cutibacterium acnes (C. acnes)-induced inflammatory nodules. Methods: Sebocytes and ORS cells were cultured and treated with either 0.1% dimethyl sulfoxide, 5 μg/ml LPS, 50 μg/ml RGAP or 5 μg/ml LPS+50 μg/ml RGAP for 6 and 24 hours.Real-time polymerase chain reaction, ELISA, Western blot analysis, and immunofluorescence staining were among the methods used to detect and quantify inflammatory cytokine production. Mice infected with C. acnes were treated with 2 weeks of RGAP provided in drinking water followed by immunohistochemical evaluation of inflammatory nodules. Results: Administration of RGAP to LPS-treated sebocytes and ORS cell cultures resulted in increased expression of inflammatory cytokines like interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-α, toll-like receptor 2, p-c-jun, p-JNK and p-iKB (p＜0.05). Administration of RGAP also resulted in increased expression of LL37 in LPS-treated sebocytes and ORS cells, and increased production of sebum in LPS-treated sebocytes (p＜0.05). RGAP also promoted increased expression of inflammatory biomarkers in C. acnes-associated inflammatory nodules in mice (p＜0.05). Conclusion RGAP may exacerbate inflammatory pathology associated with acne vulgaris. Ginseng supplements may be contraindicated in patients diagnosed with inflammatory acne.

It is challenging to treat ventriculitis with parenteral treatment alone in some cases because of the difficulty involved in maintaining an appropriate level of antibiotics in cerebrospinal fluid (CSF). We report two cases of ventriculitis who did not respond to intravenous (IV) antibiotics but were successfully treated with intraventricular antibiotics using IV agents. The first case was a four-month-old male patient with X-linked hydrocephalus.He showed ventriculitis due to Klebsiella pneumoniae not producing extended-spectrum β-lactamase and susceptible to third-generation cephalosporins and gentamicin, following ventriculoperitoneal (VP) shunt. His condition did not improve during the 47 days of treatment with IV cefotaxime and meropenem. We achieved improvement in clinical presentation and CSF profile after three times of intraventricular gentamicin injection. The patient was discharged from the hospital with antiepileptic drugs. The second case was a six-month-old female patient with a history of neonatal meningitis complicated with hydrocephalus at one month of age, VP shunt at two months of age, followed by a methicillinresistant coagulase-negative staphylococci (CoNS) shunt infection with ventriculitis after the shunt operation. CoNS ventriculitis recurred four weeks later. We failed to treat intractable methicillin-resistant CoNS ventriculitis with IV vancomycin for ten days, and thus intraventricular antimicrobial treatment was considered. Five times of intraventricular vancomycin administration led to improvement in clinical parameters. There were only neurological sequelae of delayed language development but no other major complications. Patients in these two cases responded well to intraventricular antibiotics, with negative CSF culture results, and were successfully treated for ventriculitis without serious complications.

Cardiac tamponade (CT) is a rare but potentially lethal complication associated with central venous catheters (CVCs). We present a 6-year-old boy who developed CT after CVC insertion in the right internal jugular vein, with its tip in the inferior vena cava. Initially, he was hospitalized to a tertiary hospital with presumptive diagnoses of pneumonia and left ankle cellulitis. Three days after CVC placement, he developed CT, manifesting as recurrent episodes of hypotension and bradycardia. Once a bedside echocardiography showed CT, pericardiocentesis was performed, resulting in successful resuscitation. Pericardiocentesis revealed a milk-appearing pericardial fluid, indicating chylopericardium. The boy also underwent debridement and joint irrigation of the left ankle, which turned out to be osteomyelitis. Although CVC tips in most reported CVC-related CTs have been commonly located in the right atrium, our case featured a tip located in the inferior vena cava. Additionally, chylopericardium was likely due to the extravasation of total parenteral nutrition fluid, rather than the usual causes, such as recent thoracic surgery. Understanding the mechanisms behind chylopericardium associated with CVCs and timely pericardiocentesis is crucial for improving the outcomes.

Objective: The rate of dropouts by emergency residents is relatively high in Korea, which causes harm to both medicalinstitutions and individuals. This study investigated the dropouts in emergency residents to identify the related factors. Methods: In this retrospective study, data were collected through in-depth individual interviews by telephone after thefirst interview by e-mail for residents who dropped out of emergency medicine training, and thematic analysis was conducted. Results: Three themes were identified from nine subthemes: ‘Overload,’ ‘Disposition dilemma,’ and ‘Occurrence of negativefeeling.’ Conclusion The core themes of dropout in emergency residents are complex, leading to skepticism about emergencymedicine training and a loss of self-esteem as an emergency medicine doctor. Therefore, the guidance specialist shouldexamine the appropriateness of the job of the resident to prevent the dropout in emergency medicine departments, recognizethe ambiguous patient dilemma as a problem of the emergency system, and watch for negative emotions of theresidents.

Background: It has been reported that vitamin D may play an important role in rotator cuff tears. However, there has been limited information about the prevalence of and risk factors for hypovitaminosis D in patients with rotator cuff tears. Therefore, the purpose of current study was to investigate the prevalence of and risk factors for hypovitaminosis D in patients with rotator cuff tears. Methods: One hundred seventy-six patients (age, 61.9 ± 8.90 years) who underwent arthroscopic rotator cuff repair for a fullthickness tear were enrolled in this retrospective study. Preoperative serum vitamin D levels (25-hydroxyvitamin D) were measured.Hypovitaminosis D was defined as a serum concentration of 25-hydroxyvitamin D < 20 ng/mL. We investigated whether age, sex, height, weight, body mass index, bone mineral density, alcohol consumption, smoking status, and outdoor occupation were associated with hypovitaminosis D. Results: The prevalence of hypovitaminosis D in patients with rotator cuff tears was 44.3% (78/176). The mean serum concentration of 25-hydroxyvitamin D of total patients was 24.7 ± 13.7 ng/mL. A higher serum level of vitamin D was significantly associated with older age (p < 0.001). Young age was an independent risk factor for hypovitaminosis D. The prevalence of hypovitaminosis D was also lower in patients with an outdoor occupation than in those with an indoor occupation (19.0% vs. 31.4%,p = 0.001). Conclusions The prevalence of hypovitaminosis D in patients with rotator cuff tears was 44.3%. Age had a significant positive correlation with the serum concentration of 25-hydroxyvitamin D. Young age and indoor working were independent risk factors for hypovitaminosis D in patients with rotator cuff tears. Therefore, the possibility of hypovitaminosis D should be considered for young and indoor working patients who have rotator cuff tears.

Background: It has been reported that vitamin D may play an important role in rotator cuff tears. However, there has been limited information about the prevalence of and risk factors for hypovitaminosis D in patients with rotator cuff tears. Therefore, the purpose of current study was to investigate the prevalence of and risk factors for hypovitaminosis D in patients with rotator cuff tears. Methods: One hundred seventy-six patients (age, 61.9 ± 8.90 years) who underwent arthroscopic rotator cuff repair for a fullthickness tear were enrolled in this retrospective study. Preoperative serum vitamin D levels (25-hydroxyvitamin D) were measured.Hypovitaminosis D was defined as a serum concentration of 25-hydroxyvitamin D < 20 ng/mL. We investigated whether age, sex, height, weight, body mass index, bone mineral density, alcohol consumption, smoking status, and outdoor occupation were associated with hypovitaminosis D. Results: The prevalence of hypovitaminosis D in patients with rotator cuff tears was 44.3% (78/176). The mean serum concentration of 25-hydroxyvitamin D of total patients was 24.7 ± 13.7 ng/mL. A higher serum level of vitamin D was significantly associated with older age (p < 0.001). Young age was an independent risk factor for hypovitaminosis D. The prevalence of hypovitaminosis D was also lower in patients with an outdoor occupation than in those with an indoor occupation (19.0% vs. 31.4%,p = 0.001). Conclusions The prevalence of hypovitaminosis D in patients with rotator cuff tears was 44.3%. Age had a significant positive correlation with the serum concentration of 25-hydroxyvitamin D. Young age and indoor working were independent risk factors for hypovitaminosis D in patients with rotator cuff tears. Therefore, the possibility of hypovitaminosis D should be considered for young and indoor working patients who have rotator cuff tears.