No abstract available.
Lipomatosis*

From 1993 to 1996, we have used a new modular shoulder prosthesis for the treatment of acute complex fracture of the proximal humerus. The purpose of this study is to evaluate function, pain relief, and patient satisfaction after moduiar hemiarthroplasty for proximal humerus fractures. The stucly included 12 patients (J2 shoulders) with an average age of 68.5 years (range, 60 to 84 years). According to the Neer classification system, there were 3 four-part fracture-dislocations, 5 four-part fractures, 3 three-part fractures, and #I head splitting fracture. 'fhe hemiarthroplasty was pert'ormed at an average of 4 days (range, 3 to 10 days) following injury. Deltopectoral approach was used in all patients, and the prostheses were implanted with cement in ten cases. Follow-up evaluation, at an average of 32 months post-surgery, included clinical and radio- graphic examination. Active forward elevation averaged 120 degrees; external rotation, 35 degrees; and internal rotation, to the first lumbar vertebra. All of patients, except two who had poor results, were graded as good or excellent according to UCLA shoulder rating scale. Complications consisted of one tuberosity dispiacement, one peri-operative death and one loosening of uncemented humeral prosthesis. We concluded that Modular hemiarthroplasty for acute complex fracture of the proximal humerus especially in severely osteoporotic elderly patients facilitated the restoration of humeral length, anatomic repositioning of tuberosities, and precise soft tissue balance, thereby allowing earliermotion to prevent the developement of painful shoulder stiffness.
Aged ; Classification ; Follow-Up Studies ; Head ; Hemiarthroplasty* ; Humans ; Humerus* ; Patient Satisfaction ; Prostheses and Implants ; Shoulder ; Spine

This study was conducted to evaluate the effect of VDT work on eyes and vision among workers in a TV manufacturing plant. The study subjects consisted of 264 screen workers and 74 non-screen workers who were less than 40 years old male and had no history of opthalmic diseases such as corneal opacities, trauma, keratitis, etc and whose visual acuity on pre-employment health examination by Han's test chart was 1.0 or above. The screen workers were divided into two groups by actual time for screen work in a day; Group 1, 60 workers, lesser than 4 hours a day and group 11, 204 workers, more than 4 hours a day. From July to October 1992 a questionnaire was administered to all the study subjects for the general charateristics and subjective eye symptoms after which the opthalmologic tests such as visual acuity, spherical equivalent, lacrimal function, ocular pressure, slit lamp test, fundoscopy were conducted by one opthalmologist. The proportion of workers whose present visual acuity was decreased more than 0. 15 in comparison with that on the pre-employment health examination by Han's test chart was 20.6% in Group Ii, 15.0% in Group I and 14.9% in non-screen workers. However, the differences in proportion were not statistically significant. The proportion of workers with decreased visual acuity was not associated with the age, working duration, use of magnifying glass and type of shift work (independent variables) in all of the three groups. However, screen workers working under poor illumination had a higher proportion of persons with decreased visual acuity than those working under adequate illumination (P<0.05). The proportion of workers whose near vision was decreased was 27.5% in Group II, 18.3% in Group I, and 28.4% in non-screen workers and these differences in proportion were not statistically significant. Changes of near vision were not associated with 4 independent variables in all of the three groups. Six out of sever-subjective eye symptoms except tearing were more common in Group I than in non-screen workers and more common in Group II than in Group I (P<0.01). Mean of the total scores for seven subjective symptoms of each worker (2 points for always, 1 point for sometimes, 0 point for never) was not significantly different between workers with decreased visual acuity and workers with no vision change. However, mean of the total scores for Group II was higher than those for the Group I and non-screen workers (P < 0. 01). Total eye symptom scores were significantly correlated with the grade of screen work, use of magnifying glass, and type of shift work. There was no independent variable which was correlated with the difference in visual acuity between the pre-employment health examination and the present state, the difference between far and near visions, lacrimal function, ocular pressure, and spherical equivalent. Multiple linear regression analysis for the subjective eye symptom scores revealed a positive linear relationship with actual time for screen work and shift work(P<0.01). In this study it was not observed that the VDT work decreased visual acuity but it induces subjective eye symptoms such as eye fatigue, blurred vision, ocular discomfort, etc. Maintenance of adequate illumination in the, work place and control of excessive VDT work are recommended to prevent such eye symptoms.
Adult ; Asthenopia ; Corneal Opacity ; Glass ; Humans ; Keratitis ; Lighting ; Linear Models ; Male ; Plants* ; Surveys and Questionnaires ; Tears ; Vision, Ocular ; Visual Acuity ; Workplace

This is cross-sectional study a potential relationship between air conduction hearing threshold and blood viscosity in normal adult males(n=1677). We measure hearing threshold in frequency level at 500, 1000, 2000, 4000Hz by pure-tone audiometry and RBC profiles contains red cell number, hemoglobin, hematocrit. Blood viscosity replaced by hematocrit that are one major factor of influencing blood viscosity. PTAs(pure-tone averages) measured by hearing threshold averages level at 500Hz, 1000Hz, 2000Hz by pure-tone audiometry. Grades of PTAs(pure-tone averages) are less then 10.0dB group, between 10.0-19.9dB group and excess 20.0dB. The results are significantly association among hematocrit, red cell number and hearing loss(age adjust by ANACOVA).
Adult* ; Audiometry, Pure-Tone ; Blood Viscosity* ; Cell Count ; Cross-Sectional Studies ; Hearing* ; Hematocrit ; Humans ; Male*

BACKGROUND: The flowers of Inula japonica (Inulae Flos) have long been used in traditional medicine for the treatment of inflammatory diseases. In the present study, we investigated the anti-inflammatory properties of Inulae Flos Extract (IFE). METHODS: The anti-inflammatory effects of IFE against nitric oxide (NO), PGE2, TNF-alpha, and IL-6 release, as well as NF-kappa B and MAP kinase activation were evaluated in RAW 264.7 cells. RESULTS: IFE inhibited the production of NO and the expression of inducible nitric oxide synthase (iNOS) in LPS-stimulated RAW264.7 cells. In addition, IFE reduced the release of pro-inflammatory cytokines, such as TNF-alpha and IL-6. Furthermore, IFE inhibited the NF-kappa B activation induced by LPS, which was associated with the abrogation of I kappa B-alpha degradation and subsequent decreases in nuclear p65 and p50 levels. Moreover, the phosphorylation of ERK, JNK, and p38 MAP kinases in LPS-stimulated RAW 264.7 cells was suppressed by IFE in a dose-dependent manner. CONCLUSION: These results suggest that the anti-inflammation activities of IFE might be attributed to the inhibition of NO, iNOS and cytokine expression through the down-regulation of NF-kappa B activation via suppression of I kappa B alpha and MAP kinase phosphorylation in macrophages.
Cytokines ; Dinoprostone ; Down-Regulation ; Flowers ; I-kappa B Proteins ; Interleukin-6 ; Inula ; Macrophages ; Medicine, Traditional ; NF-kappa B ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Phosphorylation ; Phosphotransferases ; Tumor Necrosis Factor-alpha

BACKGROUND: The long-term survival after operation of patients with lung cancer invading the chest wall is known to be related to regional nodal involvement, completeness of resection and depth of chest wall involvement. In this study results of complete resection are reviewed to determine survival charateristics. MATERIAL AND METHOD: Of 680 consecutive patients who were operated on for primary non-small cell carcinoma between 1988 and 1998, we retrospectively reviewed 55 patients(8.0%) who had complete resection for lung cancer invading the chest wall or parietal pleura. RESULT: Resection of the chest wall was en bloc in 29 patients(47.3%), and extrapleural in 26(52.7%). In the patients undergoing extrapleural resection, the depth of chest wall invasion was confined to the parietal pleura in all patients(100%). In the patients underging en bloc resection, the pathologic depth of invasion was into the parietal pleura alone in 9(31.0%) and into the chest wall in 20(69.0%). The follow-up rate of these patients was 100%. Hospital mortality was 5.4%(n=3). The actuarial 5-year survival rate was 26% for all hospital survivors(n=52). The actuarial 5-year survival rate of patients with T3N0M0 disease(29%) was better than that of T3N2M0 disease(18%), however, there was no significant(p=0.30) difference. The depth of chest wall invasion had no statistically significant effect on survival in our series, neither for patients with involved lymphatic metastasis nor for those without(p=0.99). CONCLUSION: These observations indicate that the good five year survival in patients with T3 NSCLC invading the chest wall resulted from complete resection. Survival of patients with lung cancer invading the chest wall after complete resection is dependent on the extent of nodal involvement and much less so on the depth of chest wall invasion.
Carcinoma, Non-Small-Cell Lung* ; Follow-Up Studies ; Hospital Mortality ; Humans ; Lung Neoplasms ; Lymphatic Metastasis ; Pleura ; Retrospective Studies ; Survival Rate ; Thoracic Wall* ; Thorax*

PURPOSE: To evaluate the usefulness of MR urography(MRU) using Half-Fourier acquisition single-shot turbospin-echo(HASTE) sequence compared with conventional intravenous urography(IVU). MATERIALS AND METHODS: Thirtyfive lesions of 32 patients who underwent MRU because of delayed excretion or nonvisualization of the ureter wereincluded in this study. HASTE MR urography was performed with a 1.0 MR imaging unit. Coronal images includingthose of the kidney, ureter and bladder were obtained in every patient using the multislice technique, and werepostprocessed by means of the maximal intensity projection technique. Scan time was 17-19 seconds. We analyzed theresults of MRU, focusing on level of obstruction, incidence of stone, ureter dilatation, and motion artifact, andin each case compared MRU findings with those of IVU. RESULTS: In 12 of 35 lesions(34.2%), MRU more effectivelydiagnosed causes of obstruction than did IVU, while in seven lesions(20%), MRU and IVU were similar. In eightlesions(22.9%), all of which were caused by a stone, IVU was better than MRU, and in a further eight, neithermodality was able to diagnose the cause. For diagnosis of the level of obstruction, MRU was better than IVU in 20of 35 lesions(57.1%), and similar to IVU in seven(20%). In three lesions(8.6%), neither modality was able todetect the level of obstruction. Four lesions not related to obstruction were polycystic renal disease, cysticrenal change, vesicovaginal fistula and extra-renal pelvis. Dilatation of the ureter was seen in 23lesions(65.8%) on MRU and in seven lesions on IVU. Thus, MRU revealed dilatation of for the ureter more efectivelythan IVU. CONCLUSION: MRU using HASTE was valuable for the detection of underlying causes and levels ofobstruction in the urinary tract, and of abnormalities in surrounding structures in patients with non-visualization of the kidney or delayed contrast excretion of the ureter, as seen on delayed IVU urogram.
Artifacts ; Diagnosis ; Dilatation ; Humans ; Hydronephrosis ; Incidence ; Kidney ; Magnetic Resonance Imaging ; Pelvis ; Polycystic Kidney Diseases ; Ureter ; Urinary Bladder ; Urinary Tract ; Urography* ; Vesicovaginal Fistula

OBJECTIVE: The purpose of this prospective study was to evaluate the efficacy and safety of screw fixation without bone fusion for unstable thoracolumbar and lumbar burst fracture. METHODS: Nine patients younger than 40 years underwent screw fixation without bone fusion, following postural reduction using a soft roll at the involved vertebra, in cases of burst fracture. Their motor power was intact in spite of severe canal compromise. The surgical procedure included postural reduction for 3 days and screw fixations at one level above, one level below and at the fractured level itself. The patients underwent removal of implants 12 months after the initial operation, due to possibility of implant failure. Imaging and clinical findings, including canal encroachment, vertebral height, clinical outcome, and complications were analyzed. RESULTS: Prior to surgery, the mean pain score (visual analogue scale) was 8.2, which decreased to 2.2 at 12 months after screw fixation. None of the patients complained of worsening of pain during 6 months after implant removal. All patients were graded as having excellent or good outcomes at 6 months after implant removal. The proportion of canal compromise at the fractured level improved from 55% to 35% at 12 months after surgery. The mean preoperative vertebral height loss was 45.3%, which improved to 20.6% at 6 months after implant removal. There were no neurological deficits related to neural injury. The improved vertebral height and canal compromise were maintained at 6 months after implant removal. CONCLUSION: Short segment pedicle screw fixation, including fractured level itself, without bone fusion following postural reduction can be an effective and safe operative technique in the management of selected young patients suffering from unstable burst fracture.
Humans ; Prospective Studies ; Spine ; Stress, Psychological

OBJECTIVE: The purpose of this prospective study was to evaluate the efficacy and safety of screw fixation without bone fusion for unstable thoracolumbar and lumbar burst fracture. METHODS: Nine patients younger than 40 years underwent screw fixation without bone fusion, following postural reduction using a soft roll at the involved vertebra, in cases of burst fracture. Their motor power was intact in spite of severe canal compromise. The surgical procedure included postural reduction for 3 days and screw fixations at one level above, one level below and at the fractured level itself. The patients underwent removal of implants 12 months after the initial operation, due to possibility of implant failure. Imaging and clinical findings, including canal encroachment, vertebral height, clinical outcome, and complications were analyzed. RESULTS: Prior to surgery, the mean pain score (visual analogue scale) was 8.2, which decreased to 2.2 at 12 months after screw fixation. None of the patients complained of worsening of pain during 6 months after implant removal. All patients were graded as having excellent or good outcomes at 6 months after implant removal. The proportion of canal compromise at the fractured level improved from 55% to 35% at 12 months after surgery. The mean preoperative vertebral height loss was 45.3%, which improved to 20.6% at 6 months after implant removal. There were no neurological deficits related to neural injury. The improved vertebral height and canal compromise were maintained at 6 months after implant removal. CONCLUSION: Short segment pedicle screw fixation, including fractured level itself, without bone fusion following postural reduction can be an effective and safe operative technique in the management of selected young patients suffering from unstable burst fracture.
Humans ; Prospective Studies ; Spine ; Stress, Psychological

Far Eastern countries including Korea show the high prevalence of hepatitis B virus carriers, so that the incidence of liver cirrhosis is higher than in western countries. But pregnancies with liver cirrhosis are rarely encountered in clinical settings, since liver cirrhosis usually develops after childbearing ages and often causes the disturbance of estrogen metabolism, resulting in severe menstrual irregularity and infertility. Therefore, little is known about the interactions between liver cirrhosis and pregnancy. Liver cirrhosis and portal hypertension are not contraindications to pregnancy but necessitate intensive monitoring throughout pregnancy because the complications of liver cirrhosis, which pose additional risks during pregnancy, are numerous and unpredictable. We report 3 cases of pregnancies in patients with liver cirrhosis with brief review of the literature.
Estrogens ; Hepatitis B virus ; Humans ; Hypertension, Portal ; Incidence ; Infertility ; Korea ; Liver Cirrhosis* ; Liver* ; Metabolism ; Pregnancy* ; Prevalence