Segmental fractures of the femoral shaft result from high energy trauma such as a traffic accident or falls, and it is frequently accompanied by multiple fractures and severe injuries to other organs. Thus it is very difficult to treat these fractures satisfactorily and several complications can be caused. Early operative intervention and rigid fixation is important to mobilize the patient and to ensure early rehabilitation. Nineteen cases of segmental fractures of the femoral shaft were treated with operative intervention(intramedullary nailing) and followed up between May 1989 and Nov. 1993.; minimal follow-up period was more than one year. Results were obtained as follows: 1. The methods of treatment were interlocking intramedullary nailing in 16 cases(colsed nailing in 7 cases, open nailing in 9 cases) and Kiintscher nailing in 3 cases. Bone grafts were done in 11 cases among 19 cases(8 cases in the interlocking nail group). 2. The closed interlocking intramedullary nailing could be obtained in more shortened operation time than in the open method. 3. There was earlier bone union time in the closed intramedullary nailing than in the open method with bone graft, but there was no statistical significance(SPSS/pc+progam). 4. There was a tendency of earlier bone union time in the proximal fracture site than in the distal fracture site.
Accidental Falls ; Accidents, Traffic ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Multiple ; Humans ; Methods ; Rehabilitation ; Transplants

No abstract available.
Adolescent* ; Humans ; Naloxone* ; Self-Injurious Behavior*

To search the effective antisense oligonucleotide that inhibit the growth of Herpes simplex virus type 1 (HSV-1), six kinds of phosphorothioate oligodeoxynucleotides (S-ODNs) were synthesized and the antiviral activity was assessed by measuring cytopathic effect in Vero cells infected with HSV-1. Of the three dodecamer S-ODNs, cornplernentary to the translation initiation site of IE2 (AS2) and scrambled S-ODN (AS1) showed more significant antiherpetic activity than AS4 complementary to the IE4. Accordingly, the antiviral effect of dodecamer S-ODN was not specific. In contrast to the no inhibitory effect of sense strand S-ODN of ICP8 (AS6), two S-ODNs complementary to the translation initiation site of ICP8 (AS3) and that of IE1 (AS5) showed potent antiherpetic activity assessed in vitro HSV-1 virus yield assay. Antiherpetic effect of AS3 was decreased in proportion to the addition of AS6. The synthesis of viral protein ICPS and IE1 were inhibited in AS3 and AS5 treated HSV-1 infected Vero cells, respectively. These findings suggest that antiherpetic effect of AS3 is specifically mediated by targeting ICPS. S-ODNs had no effect on Vero cell viability. The data suggest that the 19-mer S-ODNs may be effective in antiviral chemotherapy.
Drug Therapy ; Herpes Simplex* ; Herpesvirus 1, Human ; Oligodeoxyribonucleotides ; Phosphorothioate Oligonucleotides* ; Simplexvirus* ; Vero Cells

BACKGROUND: In the skin, it is often difficult to differentiate lymphomas from reactive lymphoid lesions by light microscopic examination. OBJECTIVE: Our purpose was to determine whether immunologic data obtained from mutine-processed specimens could be used to further objective morphologic interpretations. METHODS: We conducted an immunohistochcmical staining in 44 cases of benign and malignant cutaneous lymphoproliferative lesions using nine antibodies, including anti-CD3, UCHL1, MT1, MT2, L26, MB2, BerH2, 123C3, and MIB1. RESULTS: 1. Immunophenotyping with anti-CD3, UCHL1, MT1, L26, and MB2 was useful for the diagnosis of T cell or B cell lymphoma. However, these antibodies showed a lack of specificity for neoplastic cells, 2. Antibody to CD56, 123C3 showed positivity in 4 cases of angiocentric lymphoma, but negativity in 8 cases showing angiocentric lymphoma-like pathology. 3. Antibody to CD30, BerH2 showed positivity in all 6 cases of CD30 positive large cell lymphoma, but negativity in 6 cases showing diffuse lymphoma-like pathology. 4. Antibody to Ki-67, MIB1 showed positivity in more than 30% of infiltrating cells in 6 cases of angiocentric lymphoma, 4 cases of diffuse B cell lymphoma, and in more than 60% of infiltrating cells in 6 cases of CD30 positive large cell lymphoma. CONCLUSION: These observations suggest that immunostaining may provide useful adjunctive information in distinguishing benign from malignant cutaneous lymphoproliferations in paraffin sections.
Antibodies ; Diagnosis ; Immunophenotyping ; Lymphoma ; Lymphoma, B-Cell ; Paraffin ; Pathology ; Pseudolymphoma* ; Sensitivity and Specificity ; Skin

OBJECTIVE: Closure of a low transverse cesarean incision with one layer and two layer, we compared operative time, hemostasis, blood loss and postoperative sonohysteroperitoneographic findings. Study design: At our hospital 103 women were randomized to closure of a low transverse cesarean incision with either one continuous layer of a locking No. 1 chromic suture or two continuous of No. 1 chromic suture with the first layer locked between Mar. 1, 1998 and Dec. 31, 1998. After three months later, sonhysteroperitoneography was taken and then we evaluated uterus indirectly. RESULTS: A one layer closure required less operative time, 16 versus 20.8 minutes (p<0.01), less hemoglobin change, 0.44 versus 1.3 (p<0.01) and less suture materials (p<0.01). But postoperative follow up sonohysteroperitoneography, a one layer closure shows slightly thinning of isthmic layer of myometrium, two layer closure shows more adhesional band and both are similar other findings. CONCLUSION: A one layer does not significantly affect the clinical course than traditional two layer closure. So we recommended a one layer closure when its use is anatomically feasible.
Animals ; Female ; Follow-Up Studies ; Hemostasis ; Humans ; Mice ; Myometrium ; Operative Time ; Sutures ; Uterus

BACKGROUNDS: Since the advent of MRI, cavernous angioma has been recognized as an important cause of chronic epilepsy. However, the natural course or optimal treatment strategies of chronic epilepsy with cavernous angioma have not been established yet. METHODS: We conducted a retrospective review of the Yonsei Epilepsy Data Bank and found 13 patients with characteristic MR findings of cavernous angioma who have been followed at the Yonsei Epilepsy Clinics for longer than one year. The clinical variables and outcome of the patients were analyzed. RESULTS: The subjects consisted of 7 men and 6 women. The age of seizure-onset was approximately 21 years old and the duration of seizure were 9 years. All patients in this study had small(< 2cm) and single cavernous angioma and the majority of lesions(9/13) were located in the temporal lobe. One patient also had hippocampal atrophy and another two had combined venous malformations. After adequate trials of antiepileptic drug therapy, 5 patients became seizure free, 2 patients showed worthwhile improvement and the remaining 6 patients did not have any improvement. The withdrawal of antiepileptic drugs was tried in two patients after seizure free period of 3 years but seizure recurred in all patients. Epilepsy surgery had been performed in two patients. One patient who had the left hippocampal atrophy has been remain seizure free after a standard anterior temporal lobectomy but the other patient who had performed a lesionectomy alone did not improve after surgery. During the period of follow up for about 36 months, no symptomatic bleeding had been occurred in any patiet included to the study. CONCLUSION: The incidence of hemorrhagic events in chronic epilepsy patients with cavernous angioma is extremely low. About half of the patients can be adequately managed by antiepileptic drugs therapy but the chance of successful withdrawal of AEDs seems slim.
Anterior Temporal Lobectomy ; Anticonvulsants ; Atrophy ; Drug Therapy ; Epilepsy* ; Female ; Follow-Up Studies ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Prognosis* ; Retrospective Studies ; Seizures ; Temporal Lobe ; Young Adult

No abstract available.
Humans*

BACKGROUND: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. METHODS: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. RESULTS: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were 156.7°, 152.2°, 61.1°, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. CONCLUSIONS: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.
California ; Elbow ; Follow-Up Studies ; Humans ; Humerus* ; Joint Capsule Release ; Methods ; Postoperative Complications ; Shoulder ; Surgeons ; Suture Anchors ; Sutures

BACKGROUND: Controversy exists as to whether or not inhalation anesthetics and intravenous anesthetics impair arterial oxygenation (PaO2) during one lung ventilation (OLV). Accordingly, we examined the effect of enflurane and propofol on PaO2 and pulmonary vascular resistance (PVR) during OLV. METHODS: Forty patients, who had prolonged periods of OLV anesthesia with minimal trauma to the nonventilated lung were studied in a cross over design. Patients were randomized to four groups; Group 1 received 1 MAC of enflurane and oxygen from induction until the first 20 min after complete lung collapse, then were switched to propofol 100 g/kg/min (P100). In group 2, the order of the anesthetics was reversed. Group 3, Group 4 received the same order of the anesthetics as Group 1, Group 2, respectively but received propofol 200 g/kg/min (P200). RESULTS: During OLV, the PaO2 values were lower than those with two lung ventilation (TLV), there were no significant differences among each groups and between propofol and enflurane in PaO2, but in the selected patients (n=10, PaO2<120 mmHg during OLV), PaO2 in propofol group was higher than that of enflurane group (p<0.05). Conversion from TLV to OLV caused a significant increase in PVR, but there were no difference in PVR between propofol and enflurane group. CONCLUSIONS: These results suggest that the usual clinical dose of propofol affords no advantage over 1 MAC of enflurane anesthesia except low PaO2 patients during OLV. Propofol might be of value in risk patients of hypoxemia during thoracic surgery when OLV is planned.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Anoxia ; Cross-Over Studies ; Enflurane* ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Propofol* ; Pulmonary Atelectasis ; Thoracic Surgery ; Vascular Resistance ; Ventilation

No abstract available.
Genomic Library* ; Helicobacter pylori* ; Helicobacter*