No abstract available.
Perfusion* ; Peripheral Arterial Disease*

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

STUDY DESIGN: A retrospective study. OBJECTIVES: To find the causative factors which induce decompensation after selective thoracic fusion with segmental pedicle screw fixation in King type II AIS. SUMMARY OF LITERATURE REVIEW: Pedicle screw fixation enabling enhanced correction is increasing in use in idiopathic scoliosis. However, there are few reports on the decompensation after selective thoracic fusion with pedicle screw fixation in King type II AIS. MATERIALS AND METHODS: Thirty-nine King type II AIS patients subjected to selective thoracic fusion with pedicle screw fixation were analyzed after a minimum follow up of 1 year. They were reviewed using standing roentgenograms. Deviation of center of T1 from center sacral line greater than 2 cm was considered decompensation. RESULTS: Among 39 patients, compensation was in 35 while decompensation in 4 postoperatively. There was no significant differences between the two groups in preoperative thoracic or lumbar curve characteristics such as curve magnitude, apical deviation or apical rotation. There was a significant difference in thoracic curve correction and postoperative T-curve magnitude divided by preoperative L-curve respectively(p= 0.001). CONCLUSION: Decompensation with selective thoracic fusion with segmental pedicle screw fixation in King type II AIS was not induced by preoperative L-curve characteristics nor derotation maneuver. The factor of decompensation was overcorrection, i.e. if thoracic curve correction was more than 75% or if the magnitude of postoperative T-curve was 30% less than that of preoperative L-curve, there was a high risk of decompensation.
Adolescent* ; Compensation and Redress ; Follow-Up Studies ; Humans ; Retrospective Studies ; Scoliosis*

STUDY DESIGN: This is a prospective design. SUMMARY AND BACKGROUND DATA: Derotation makes powerful coronal and satisfactory sagittal correction, however, making rotational correction is still controversy. OBJECTIVES: To introduce a new technique to improve the vertebral rotation. METHODS: 1. Fix the pedicle screws of concave side of thoracic spine with nut driver or derotator before derotation maneuver. 2. During the derotation (counter-clockwise), rotate the nut driver/derotator to the opposite direction (clockwise). RESULTS: A King type II AIS girl with the magnitude of right thoracic and left lumbar curve was 54 degrees and 40degress respectively was reviewed. Thoracic apical rotation was checked 32 degrees. When derotation maneuver was done, the Cobbs angle of thoracic verteba was corrected to 14 degrees (74.1%), however the apical angle was aggravated to 34 degrees . When derotation-screw rotation(DSR) was done, thoracic angle was corrected to 3 degrees with 94.4% of curve correction. The apical rotation was improved to 25 degrees. Preoperative 19.6 degrees of RAsac was corrected to 10.4 degrees showing 46.9% of correction. Postooperatively she was balanced inspite of overcorrection. CONCLUSION: Derotation itself did not improve or slightly aggravate the rotation of apical vertebra. Apical rotation was dramatically improved by derotation combined by screw rotation technique. Maximal curve correction was obtained without trunk decompensation. This new technique may replace the advantages of anterior instrumentation in better rotational correction and saving fusion levels.
Congenital Abnormalities* ; Female ; Humans ; Nuts ; Prospective Studies ; Scoliosis* ; Spine

Neurological manifestations are commonly observed in systemic lupus erythematosus (SLE). However, cerebellar involvement has rarely been reported. We report a case of SLE presented with cerebellar ataxia as an initial manifestation after influenza vaccination. A 38-year-old woman who had not been diagnosed with SLE presented with dysarthria and gait disturbance after influenza vaccination. On admission, cerebellar ataxia and bilateral sixth cranial nerve palsy were observed. Influenza vaccination may have triggered autoimmunity in the patient with SLE.
Abducens Nerve Diseases ; Adult ; Autoimmunity ; Cerebellar Ataxia ; Dysarthria ; Female ; Gait ; Humans ; Influenza Vaccines ; Influenza, Human ; Lupus Erythematosus, Systemic ; Neurologic Manifestations ; Vaccination

Histamine H2-receptor antagonists are commonly used in many clinical conditions, and their hepatotoxicity has been reported occasionally.However, cholestatic hepatitis induced by nizatidine is very rare. Here, we report a young female patient with severe cholestatic hepatitis associated with nizatidine use. She had taken nizatidine to manage asymptomatic reflux laryngitis by an otonasolaryngology doctorfor about 20 days. After about 15 days of nizatidine administration, jaundice developed and continued for more than2 months withmaximal serum total bilirubin reaching 17.5 mg/dL, in spite of the discontinuation of medication. Liver specimen obtained by needle biopsy revealed severe centrilobular cholestatic hepatitis. Her liver function improved slowly and serum total bilirubin decreased down to 1.7 mg/dL after months later from the development of jaundice. As far as our knowledge, this is the second case of nizatidine- induced cholestatic hepatitis reported in the literature.
Bilirubin ; Biopsy, Needle ; Cholestasis ; Female ; Hepatitis* ; Histamine ; Humans ; Jaundice ; Laryngitis ; Liver ; Nizatidine*

PURPOSE: To compare the radiological and clinical results of Wayne-County reduction with anatomical reduction in treatment of the intertrochanteric fractures of the femur in elderly patients. MATERIALS AND METHODS: Among one hundred-three of intertrochanteric fractures treated with 135- degree angled compression hip scresw, eighty three cases treated by Wayne-County reduction (Group 1, 42 cases) and anatomical reduction (Group 2, 41 cases) with at least 1 year follow-up were reviewed. The average pateint ages were 72.4 (65~92) in group 1, 71.6 (65~89) in group 2, respectively. 33 cases (75.2%) in group 1 and 31 cases (77.5%) displayed unstable fractures by Jensen classification. The radiological observation was included neck-shaft angle, penetrating length of lag screw into head, sliding length of lag screw and time of bony union. The clinical results were evaluated by Koval criteria, Kyle's functional evaluation, leg length inequality and complications. RESULTS: There were no significant changes between group 1 and group 2 in stable fractures in the radiological and clinical results. In unstable fractures, the neck-shaft angle averaged 132.2 degree in group 1 and 129.4 degree in group 2 in the final follow-up films. The penetrating length of lag screw into head were 2.2 mm in group 1 and 3.1 mm in group 2 (p<005). But there were little differences in the sliding length of lag screw, the time of bony union and complication rates between groups. In post- operative evaluation of walking abilility by Koval, 31 patients (73.8%) in group 1 and 28 (68.3%) recovered the activity level before injury by the postoperative 1 year follow-up. Leg length discrepancy at final follow-up was 4.1+/-6 mm shortening in group 1 and 6.5+/-8 mm in group 2, respectively. CONCLUSION: Both Wayne-County reduction and anatomical reduction had a favorable results after treatment of stable intertrochanteric fractures of the femur, but Wayne-County reduction may be a better method in treatment of unstable fractures, especially in elderly patients, in which it is difficult to obtain anatomical reduction.
Aged* ; Classification ; Femur* ; Follow-Up Studies ; Head ; Hip ; Hip Fractures* ; Humans ; Leg ; Leg Length Inequality ; Walking

BACKGROUND AND OBJECTIVES: The benefit of high glucose-insulin-potassium (GIK) solution in clinical applications is controversial. We established a neonatal rat ventricular myocyte (NRVM) in vitro coverslip ischemia/reperfusion (I/R) model and investigated the effects of GIK solution on suppressing reactive oxygen species (ROS) and upregulating O-GlcNacylation, which protects cells from ischemic injury. MATERIALS AND METHODS: NRVMs were isolated from postnatal day 3-4 Sprague-Dawley rat pups and grown in Dulbecco's modified Eagle's medium containing high glucose (4.5 g/L), fetal bovine serum, and penicillin/streptomycin. The effects of the GIK solution on ROS production, apoptosis, and expression of O-GlcNAc and O-GlcNAc transferase (OGT) were investigated in the coverslip I/R model. RESULTS: Covering the 24-well culture plates for 3 hr with 12 mm diameter coverslips resulted in the appropriate ischemic shock. Glucose and insulin synergistically reduced ROS production, protected NRVM dose-dependently from apoptosis, and altered O-GlcNAc and OGT expression. CONCLUSION: The high GIK solution protected NRVM from I/R injury in vitro by reducing ROS and altering O-GlcNacylation.
Animals ; Apoptosis ; Glucose ; Insulin ; Muscle Cells* ; Myocytes, Cardiac ; Rats* ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Shock ; Transferases

Pancreatic pseudocyst is a well-known complication of pancreatitis. However spontaneous perforation and/or fistularization is rare. Perforations into the free peritoneal cavity, stomach, duodenum, colon, portal vein, pleural cavity, and through the abdominal wall have been reported. Rupture of pseudoaneurysm or bleeding pseudocyst following pancreatitis is a severe complication that can lead to massive gastrointestinal bleeding. Especially, rupture of a bleeding pseudocyst into the stomach combined with splenic artery pesudoaneurysm is very rare. We experienced a case of massive bleeding from pancreatic pseudocyst with pseudoaneurysmal rupture into the stomach which was controlled nonoperatively by splenic artery coil embolization and conservative treatment. We report the case with the literatures review.
Abdominal Wall ; Aneurysm, False ; Colon ; Duodenum ; Embolization, Therapeutic ; Hemorrhage* ; Pancreatic Pseudocyst* ; Pancreatitis ; Peritoneal Cavity ; Pleural Cavity ; Portal Vein ; Rupture* ; Splenic Artery ; Stomach*