No abstract available.
Hepacivirus* ; Hepatitis C* ; Hepatitis*

No abstract available.
Aged* ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Hypercholesterolemia*

BACKGROUND: The purpose of this study is to compare the radiological and clinical outcomes after open reduction and plate fixation of midshaft clavicle fractures between patients who achieved successful anatomical reduction and those who had a remaining fracture gap even after open reduction and plate fixation, and were thus treated with additional demineralized bone matrix (DBM). METHODS: This retrospective analysis was conducted on 56 consecutive patients who underwent open reduction and internal fixation using a locking compression plate for acute displaced midshaft clavicle fractures, and who underwent radiographic and clinical outcome evaluations at least 6 months postoperatively. The outcomes between those who achieved perfect anatomical reduction without remnant gap (n=32) and those who had a remaining fracture gap even after open reduction and plate fixation treated with additional DBM (n=24) were evaluated. RESULTS: There were no differences in the use of lag screws or wiring and operation time (all p>0.05) between those with and without remnant gap. No difference in the average radiological union time and clinical outcomes (satisfaction and Constant score) was observed between the two groups (all p>0.05). However, significantly faster union time was observed for AO type A fracture compared with other types (p=0.012), and traffic accident showed association with worse clinical outcomes compared with other causes of injury. CONCLUSIONS: Surgical outcome of midshaft clavicle fracture was more affected by initial fracture type and event, and re-reduction and re-fixation of the fracture to obtain a perfect anatomical reduction spending time appears to be unnecessary if rigid fixation is achieved.
Accidents, Traffic ; Bone Matrix ; Clavicle* ; Fracture Fixation ; Fracture Healing ; Humans ; Retrospective Studies

No abstract available.
Humans ; Moral Development* ; Students, Medical*

BACKGROUND: Because of wide individual variations in response to sedative and the level of sedation desired by different patients, inadequate sedation is frequent during surgery. Patient-controlled sedation is a logical extension of patient-controlled analgesia to find and maintain their own steady-state of sedation by self-administration of sedatives during surgery. The purpose of this study was to evaluate the feasibility of patient-controlled sedation compared with anesthesiologist-controlled sedation during surgical spinal anesthesia. METHODS: Unpremedicated forty adult patients who received spinal anesthesia for lower extremity surgery were randomly allocated into two groups (n=20 for each group). After selection of target state of sedation according to sedation scale, patient-controlled sedation (PCS) group self-administered 0.5 mg (1 ml) intravenous midazolam in increments using a Walkmed PCA infusor and anesthesiologist- controlled sedation (ACS) group administered by the anesthesiologist as the same manner to achieve previously selected sedation state. Sedation score, vital signs, SpO2 were checked 5, 10, 20, 30, 40min after start of drug injection. RESULTS: The sedation scores patient desired were 4.4 +/- 0.8 in PCS group and 4.3 +/- 0.7 in ACS group. These scores were achieved 20min after start of injection in PCS group and 40 min in ACS grou p (p<0.05). Degree of satisfaction was higher in PCS group compared with ACS group (1.5 +/- 0.6 vs 2.1 +/- 0.8, p<0.05). No complications were detected in two groups. CONCLUSIONS: PCS using midazolam was better than ACS in terms of early achievement of sedation state patient desired and degree of satisfaction.
Adult ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Humans ; Hypnotics and Sedatives ; Infusion Pumps ; Logic ; Lower Extremity ; Midazolam* ; Passive Cutaneous Anaphylaxis ; Vital Signs

Iris neovascularization was produced in rabbits by hypotony following repeated aspiration of the vitreous. The hypotony was produced after 0.3 ml of vitreous fluid was aspirated using a 25-gauge needle through the pars plana of 10 rabbits. For the histochemical study, horseradish peroxidase(HRP) was injected through the ear lobe vein. After fixation of the iris tissue, the tissue was treated with diaminobenzidine and examined with both light microscopy and transmission electron microscopy. The newly-formed vessel was abundant, particularly on the upper stroma of the iris. The new vessel formation was evident due to the proliferation of endothelial cells, which may have been derived from preexisting iris vessels. The endothelial cells of the newly-formed vessels revealed prominent villous processes into the vascular lumen, formation of the marginal flap, numerous fenestrations in the endothelial junction, and reaction product onto extravascular space by the cytochemical electron microscopy. These results suggest that hypotony in the rabbit produces the disruption of the blood-iris barrier and the balance between angiogenesis-antiangiogenesis modulation.
Animals ; Biological Transport, Active ; Disease Models, Animal ; Horseradish Peroxidase/diagnostic use ; Iris/*blood supply/*ultrastructure ; Iritis/*pathology ; Neovascularization, Pathologic/*pathology ; Rabbits ; Vitreous Body/surgery

To examine prospectively the efficacy and reliability of excimer laser photorefractive keratectomy for myopia. we treated 147 eyes of 86 patients with a VisX Twenty/Twenty excimer laser and followed them up for 1 year and follow up 48 eyes of 26 patients for 2 years. The patients were divided into two groups with preoperative myopia: group 1 with diopters between -1.50 and -6.00, group 2 with diopters between -6.01 and -10.00. At 1 year, the group 1 with a mean preoperative refractive error of -4.61D changed to -0.40D, the group 2 changed from -7.50D to -0.92D. At 2 years, the group 1 with a mean preoperative refractive error of -4.28D changed to -0.41D, the group 2 changed from -7.75D to -1.04D. At 1 yera, in group 1, 90.91% (70 of 77) of eyes and in group 2, 64.29%(45 of 70) of eyes were corrected within 1D of intended refraction,respectively. At 1 years, in group 1, 94.81% (73 of 77) of eyes and in group 2, 84.29%(59 of 70) of eyes achieved an uncorrected visual acuity of 0.5 or better. And at 2 years, in group 1, 81.82% (18 of 22)of eyes, and in group 2, 50.00% (13 of 26) of eyes were corrected within 1D of intended refraction, respectively. At 2 years, in group 1, 95.50% (21% of 22) of eyes and in group 2, 84.62%(22 of 26) of eyes achieved an uncorrected visual acuity of 0.5 or better.
Follow-Up Studies* ; Humans ; Lasers, Excimer* ; Myopia* ; Photorefractive Keratectomy* ; Prospective Studies ; Refractive Errors ; Visual Acuity

Various foreign implants(silicone, gel film, Mersilene and chromic cat gut) were used for cyclodialysis operation on rabbit eyes. We observed the changes of intraocular pressures, inflammatory state and course of complicated hyphema in these eyes for six weeks. Each eye was removed four to six weeks after the operation for histopathologic studies. On slit lamp biomicroscopy, hyphema was subsided within seven to ten days. Intraocular pressures were so inconsistent that we could not get any contributory informations from them. Histopathologic findings revealed much differences according to the foreign implants applied; Inflammatory reaction was severe in chromic cat gut inserted group, moderate in Mersilene and gel mm inserted group, and mild in silicone inserted group. Foreign body reaction was most marked in Mersilene inserted group and less marked in chromic cat gut, gel film and silicone inserted group. Silicone was not absorbable, and chromic cat gut and Mersilene were hardly absorbable in contrast to easy absorption of gel film. Suprachoroidal space was remained open in silicone inserted group during the period of observation. The space was equivocal in gel film and Mersilene inserted group and completely closed in chromic cat gut inserted group. According to the above histopathologic findings, silicone was the best one as an implant for cyclodialysis operation in rabbit eyes.
Absorption ; Animals ; Cats ; Foreign-Body Reaction ; Hyphema ; Intraocular Pressure ; Rabbits* ; Silicones

The whole retina, except for the medullary fiber zone in a rabbit eye, is supplied by choroidal circulation. Therefore, the histopathological changes of the sensory retina due to choroidal circulatory disturbance in rabbits may be comparable to that of the human sensory retina in the case of ophthalmic artery occlusion. This study was carried out to evaluate the histopathological changes of the ischemic retina secondary to the occlusion of choroidal circulation. The experimental occlusion of all posterior ciliary arteries and anterior ciliary arteries in the horizontal rectus muscle of rabbit eyes was performed and the subsequent histopathological changes of the sensory retina were observed by transmission electron microscopy. The morphological changes of the sensory retina following the occlusion of the ciliary arterial system are as follows: severe loss of the inner and outer segments of the photoreceptor, mild to moderate degeneration of the ganglion cells, and excellent preservation of the Muller's cell fibers and the extension of the cytoplasmic villous processes to the cytoplasmic vacuolar spaces of other degenerated cells. These findings indicate that the Muller's fibers in the ischemic condition of retina might contribute to the formation of gliosis or scarring of a damaged retina.
Animals ; Arterial Occlusive Diseases/*complications ; Arteries ; Choroid/*blood supply ; Ciliary Body/*blood supply ; Ischemia/*etiology/pathology ; Rabbits ; Retina/*ultrastructure ; *Retinal Vessels

Folliculosebaceous cystic hamartoma (FCH) is a recently recognized adnexal tumor and is composed of follicular, sebaceous and mesenchymal elements such as small vessels, adipocytes and neural component in the fibrous stroma. It usually presents as an exophytic papule or nodule on the central part of the face. We describe a 39-year-old woman with FCH on the right upper back, which is an unusual site. A biopsy specimen demonstrated a follicular structure in infundibuiar nature, sebaceous lobules attached to it, and compactly laminated fibrous stroma with an increased number of vessels in it. Immunohistochemically, many of the vessels in the stroma showed positive reaction for CD34, and Factor VIII.
Adipocytes ; Adult ; Biopsy ; Factor VIII ; Female ; Hamartoma* ; Humans