BACKGROUND: The purpose of our study was to evaluate the accuracy of reduction based on postoperative computed tomography (CT) images after arthroscopic stabilization using tightrope system for unstable distal clavicle fracture. METHODS: Twelve patients with distal clavicle fracture combined with coracoclavicular (CC) ligament injury (type II, V) who received arthroscopically assisted fixation using a flip button device were evaluated for accuracy of reduction using 3-dimensional postoperative CT scan by measuring the degree of distal clavicular angulation and clavicular shortening. RESULTS: Immediate postoperative plain radiograph confirmed restoration of the CC distance (CCD) in 10 patients. At final follow-up, the CCD remained reduced anatomically on plain radiographs in these patients. All patients showed excessive posterior angulation and shortening compared to the opposite side. The average Constant score recovered to 94.8 at final follow-up. CONCLUSIONS: Indirect reduction and arthroscopic subacromial approach with flip button fixation of unstable distal clavicle fractures demonstrated favorable clinical results despite unavoidable posterior angulation of distal clavicle and shortening the total length of clavicle.
Arthroscopy ; Clavicle ; Follow-Up Studies ; Humans ; Ligaments ; Tomography, X-Ray Computed

No abstract available.
Amniotic Fluid* ; beta-Endorphin* ; Female

Pregnolone[5beta-pregnan-3alpha-ol-one(5beta3alpha)] and allopregnanolone [(5alpha-pregnan-3alpha-ol-20-one(5alpha3alpha))] are neuroactive steroids that are reduced metabolites of progesterone. It was reported that Neuroactive steroids may have anxiolytic and anticonvulsant action similar to benzodiazepines and barbiturates. Therefore, the present study was designed to assess the interaction of steroids with GABAA-benzodiazepine receptor complex. The effect of steroids on the ligands binding to GABAA receptor complex was investigated using rat cortices. 5beta3alpha and 5alpha3alpha enhanced the binding of [3H] flunitrazepam to GABAA receptor, but testosterone, progesterone and dexamethasone did not. GABA also showed the enhancement of [3H] flunitrazepam binding, but did not show the additive effect. Unlike to GABA, 5beta3alpha and 5alpha3alpha did not affect on the [3H] muscimol binding to rat cortices. From these findings, it can be concluded that Neuroactive steroids are potent positive modulators of the GABA A receptor, and do not act at GABA binding site.
Animals ; Barbiturates ; Benzodiazepines ; Binding Sites ; Dexamethasone ; Flunitrazepam ; gamma-Aminobutyric Acid ; Ligands ; Muscimol ; Pregnanolone ; Progesterone ; Rats ; Receptors, GABA-A ; Steroids* ; Testosterone

BACKGROUND: Use of venous catheter is associated with increased mortality in hemodialysis patients, but little data are available on impact of vascular access type on the discrepancy between dialysis prescription and dose. Dialysis prescription commonly exceeds the delivered dialysis dose. The purpose of this study are to evaluate the dialysis dose and efficiency between a tunneled cuffed catheters (TCCs) and arteriovenous fistulas (AVF) to the same patients on different dialysis days. METHODS: This study enrolled 35 hemodialysis patients. All patients started dialysis via tunneled cuffed catheters (Permcath(R)) in the internal jugular vein and a vascular surgeon created AVF later. We investigated prescribed spKT/V (pKt/V) and delivered spKt/V (dKt/V) within 2 months after the TCCs placement and after the AVF cannulation. Dialysis efficiencies (dKt/V/pKt/V) were compared over this two distinct times. RESULTS: Patient demographics were similar between two distinct times. The mean age of patients was 52.7 years (18 men, 17 women) and mean BMI was 21.9. 17 patients (48.6%) were diabetics. The mean pKt/V was not different (TCCs 1.63+/-0.30; AVF 1.62+/-0.29) but mean dKt/V was significantly different (TCCs 1.38+/-0.31; AVF 1.46+/-0.34) (p<0.05). The dialysis efficiencies were 85.14% for TCCs and 90.74% for AVF (p<0.05). There were no differences in sex, or diabetics. Underdialysis (delivered spKt/V <1.3) was greater in TCCs (17/35; 48.6 %), compared to AVF (10/35; 28.6%). Underdialysis was more common in larger patients. CONCLUSION: Our data suggest that AVF tend to receive more dialysis dose than tunneled cuffed catheters and underdialysis exposure are more common with catheter use.
Arteriovenous Fistula ; Catheterization ; Catheters ; Demography ; Dialysis* ; Humans ; Jugular Veins ; Male ; Mortality ; Prescriptions ; Renal Dialysis*

BACKGROUND/AIMS: It is very important that people living with HIV (PLWH) maintain 95% medication adherence to increase health-related quality of life and prevent transmitting HIV. In this study, we analyzed factors influencing medication adherence among PLWH and used the basic data for practical interventions to increase medication adherence. METHODS: A total of 190 PLWH, who were taking highly active antiretroviral therapy (HAART) from nine hospitals in South Korea, were included. The data were collected by self-administered questionnaire between April 1 and June 31, 2014. RESULTS: About 92% of the subjects were male and 72.9% of the subjects belonged to the high compliance group. Medication-taking self-efficacy was significantly related to compliance. Efficacy expectancy, which is a subscale of medication-taking self-efficacy, indicated that a score of 1 point higher on a 10-point scale increased compliance by 2.63 times. CONCLUSIONS: Medication adherence is associated with increased medication-taking self-efficacy. Therefore, it is necessary to promote self-efficacy to improve compliance considering the infection period and adverse reactions to HAART among PLWH.
Antiretroviral Therapy, Highly Active ; Compliance ; HIV* ; Humans* ; Korea ; Male ; Medication Adherence* ; Quality of Life ; Self Efficacy

BACKGROUND AND OBJECTIVES: The patient presenting to the emergency department with the complaint of dizziness is one of the most common as well as most challenging problems confronting the emergency physician today. Dizziness is a vague symptom of disease ranging from serious to benign. The differential diagnosis and proper management of dizziness in a department of emergency medicine are the most important things. We undertook this study to evaluate the character and clinical analysis of the dizzy patients and to discuss the significance and necessity of primary care in a department of emergency medicine. MATERIALS AND METHOD: From September 1999 to October 2003, we sampled the 1,371 dizzy patients who visited the Emergency Department(ED). Of these patients, the 650 patients performed electronystagmography(ENG) and rotatory chair test were selected, except for the patients with loss of consciousness, known psychiatric disease or direct brain injury. RESULTS: The 650 patients were attributed to acute peripheral vestibulopathy in 88.5% (575 patients) of patients, benign paroxysmal positional vertigo in 9.5% (62 patients) of patients, central origin in 1.4% (9 patients) of patients, other organic origin in 0.6% (4 patients) of patients. In a retrospective analysis of patients with central origin, the symptoms estimated at central origin, for example, persistent headache, were found. CONCLUSION: The exact diagnosis and management for the dizzy patients in a department of emergency medicine require the primary physician's concern and understanding for dizziness.
Brain Injuries ; Diagnosis ; Diagnosis, Differential ; Dizziness ; Emergencies* ; Emergency Medicine* ; Emergency Service, Hospital ; Headache ; Humans ; Primary Health Care ; Retrospective Studies ; Unconsciousness ; Vertigo ; Vestibular Neuronitis

Peritonitis is a major complication of continuous ambulatory peritoneal dialysis and it remains the leading cause of patient droupout. VRE is a very serious pathogen because it is difficult to eradicate due to very limited effective antibiotics and because there is a possibility of transfer of this resistance to other gram-positive organisms including Staphylo-coccus aureus. We experienced a case of CAPD peritonitis by VRE, which was treated with high dose ampicillin and streptomycin without removal of CAPD catheter. We report our experience of CAPD peritonitis caused by VRE and review the literature.
Ampicillin ; Anti-Bacterial Agents ; Catheters ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Streptomycin ; Vancomycin*

BACKGROUND: Docetaxel has been effectively used as an anti-cancer chemotherapuetic agent for various tumor treatments including lung cancer. However, the cell death induction mechanism(s) involved with docetaxel treatment in lung cancer cells has not been known yet. MATERIAL AND METHOD: In the present study, the cellular and biochemical changes of NCI-H1703 cells (non-small cell lung cancer cell line, p53-mutant) after docetaxel treatment have been monitored by flow cytometry, fluorescence microscopy and western blot. RESULT: Docetaxel treatment significantly resulted in decrease of S phase as well as increase of G2 phase, and consequently evoked an increase of cell death in NCI-H1703 cells. After docetaxel exposure the activations of caspase-3 and caspase-9 were detected. CONCLUSION: Take together, it is suggested that the docetaxel induces NCI-H1703 cell death by caspase-9 and caspase-3 dependent mitochondrial apoptotic pathway.
Blotting, Western ; Carcinoma, Non-Small-Cell Lung* ; Caspase 3 ; Caspase 9 ; Cell Death* ; Cell Line* ; Flow Cytometry ; G2 Phase ; Lung Neoplasms ; Microscopy, Fluorescence ; S Phase

A case is reported of downbeat nystagmus associated with compression of the root of vestibulocochlear nerve by vertebral arteries, which was revealed by magnetic resonance imaging. Chief complain of the patient was positional vertigo, which aggrevated at left decubitus position. Downbeat nystagmus was increased in left Dix-hall pike test. Tetsuo et al, reported downbeat nystagmus with compression of dolichoectatic vertebral arteries to the medulla oblongata and surgical neurovascular decompression of the dolichoectasia reverses the progression of symptoms if permanent neurologic damage has not already occurred.
Decompression ; Esocidae ; Humans ; Magnetic Resonance Imaging ; Medulla Oblongata ; Nystagmus, Pathologic ; Vertebral Artery* ; Vertebrobasilar Insufficiency ; Vertigo ; Vestibulocochlear Nerve*

Poikiloderma is a combination of telangiectasia, irregular mottled hyperpigmentation/depigmentation and superficial atrophy in a reticular pattern. Poikiloderma of Civatte is a rather common, acquired poikiloderma of the face and neck, most often affecting the middle-aged or the elderly. Poikiloderma of Civatte runs a chronic, benign, but irreversible course. The ideal treatment is elimination of both the vascular and pigmented components simultaneously. Most methods to treat this condition are ineffective, inefficient, or inconvenient and may cause significant side effects such as depigmentation and scarring. Recently, intense pulsed light sources have been used in poikiloderma of Civatte with their ability to target vascular and pigment components simultaneously. We experienced two cases of poikiloderma of Civatte treated by intense pulsed light with different parameters than those used in former reports, so we report this case with a review of previously published cases.
Aged ; Atrophy ; Cicatrix ; Humans ; Light ; Neck ; Telangiectasis ; Thorax