Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.
Acromion ; Arthroscopy ; Debridement ; Decompression ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Humans ; Humeral Fractures ; Hypertrophy ; Rotator Cuff ; Shoulder ; Shoulder Pain ; Sutures ; Tendons

Cutaneous focal mucinosis is a rare disease which usually manifests itself as a single asymptomatic papule or nodule, but vesicular presentati:on has only rarely been reported. This condition is one of many mucinoses, including localized lichen myxedematosus, acral persistent papular mucinosis, alopecia mucinosa, follieular mucinosis, and myxoid cysts which present with localized cutaneous lesions. We report a rare vesicular form of cutaneous focal mucinosis in a 42-year-old caucasian male who showed a slowly growing, 0.5 cm-sized, asymptomatic vesicle of one-week duration on his right knee. A histopathological examination revealed a localized accumulation of amorphous basophilic material which was positive on colloidal iron staining at pH 2.5. However, it was negative at pH 0.4 in an alcian blue stain, and negative on colloidal iron staining after treatment with hyaluronidase. The amorphous material was judged to be hyaluronic acid from the results of the above special stains. Proliferation of fibroblasts was also observed. Electron microscopy showed well-develuped endoplasmic reticulum and secretory vesicles in the fibroblasts. The lesion could not be completely removed even after two succesive wide excisions.
Adult ; Alcian Blue ; Basophils ; Colloids ; Coloring Agents ; Endoplasmic Reticulum ; Fibroblasts ; Ganglion Cysts ; Humans ; Hyaluronic Acid ; Hyaluronoglucosaminidase ; Hydrogen-Ion Concentration ; Iron ; Knee ; Male ; Microscopy, Electron ; Mucinoses* ; Mucinosis, Follicular ; Rare Diseases ; Scleromyxedema ; Secretory Vesicles

No abstract available.
DNA* ; Humans* ; Papilloma* ; Respiratory System*

Fifteen cases of genital warts were examined for the presence of human papillomavirus (HPV) using polymerise chain reaction (PCR). HPV6/11 DNA were found in all cases of genital warts. The PCR based methods described here provide a sensitive, accurate means of detecting genital HPVs.
Condylomata Acuminata ; DNA ; Humans* ; Papillomaviridae* ; Polymerase Chain Reaction*

Mobility shifts in non-denatured gel electrophoresis of PCR-amplified Rif' region in each of fifteen different mutants of M. tuberculosis were discerned by single strand conformation polymorphism (SSCP) analysis. The findings of mobility differences between rifampin-resistant and susceptible strains showed an excellent agreement with data obtained by traditional susceptibility test. SSCP-PCR seemed to replace the cultivation method of susceptibility test that was known to be time-consuming, labor wasting, and skeptical in quality control. After screening of rpoB gene mutation by SSCP-PCR, detection of specific sequence changes in the region of rpoB gene was attempted through the procedures of PCR-amplification, cloning of PCR-products using pGEM-T vector and DNA thermocycling sequencing. Fifteen different types of mutations were identified among fifty strains of rifampin-resistant strains while five rifampin-susceptible control strains showed no sequence changes of rpoB gene as well as reference strain H37rv. Most mutation appeared to be a point mutation due to substitution or deletion except seven mutants showing somewhat complex mutation. Each of mut#ated loci inclined to clustering within a region of eighteen amino acids involving eight codons. The most common mutation of Ser425 shared among twenty-nine mutants and followed by eleven mutants of His420. Several mutants alleles identified in this study appeared to be dissimilar to those of previous reports.
Alleles ; Amino Acid Substitution* ; Amino Acids ; Clone Cells ; Cloning, Organism ; Codon ; DNA ; Electrophoresis ; Mass Screening ; Mycobacterium tuberculosis* ; Mycobacterium* ; Point Mutation ; Quality Control ; Rifampin* ; Tuberculosis

BACKGROUND: Osteoporosis is an important health concern among the postmenopausal women. Therefore, it is necessary to find out acceptable screening tools for osteoporotic patients. The purpose of this study was to evaluate the Risk Index by OSTA as a screening test for osteoporosis. METHODS: The study population was 322 naturally caused menopausal women in Korea. Their was of femoral neck and lumbar spine BMD measured by DEXA. Risk Index by OSTA, based on weight and age, was calculated and the sensitivity and specificity for osteoporosis and osteopenia were evaluated. To find out the proper cut-off point for osteoporosis and osteopenia among the postmenopausal women in Korea, we also compared the sensitivity and specificity of each Risk Index value. RESULTS: The mean age and ages at menopause were 59.1(+/-6.2) and 50.7 (+/-2.7) years, respectively. The prevalence of osteoporosis was 9.6% with femoral neck BMD. For oeteoporosis, using a cut-off point of -1 yielded a sensitivity of 74.3% and a specificity of 52.2% with femoral neck BMD. Using a cut-off of -2 yielded a sensitivity of 87.3% and a specificity of 70.9%. The ROC curve showed an AUROC 0.88 for Risk Index in identifying osteoporosis. CONCLUSION: The Risk Index is an acceptable, simple and useful method in the diagnosis of osteoporosis with a Risk Index of -2 in Korean postmenopausal women.
Bone Diseases, Metabolic* ; Diagnosis ; Female ; Femur Neck ; Humans ; Korea ; Mass Screening* ; Menopause ; Osteoporosis* ; Prevalence ; ROC Curve ; Sensitivity and Specificity ; Spine

No abstract available.
Muir-Torre Syndrome*

No abstract available.
Fetus*

Serial changes of serum IgE, IgG, eosinophils were observed in 25 patients with acute myocaridial infarction and 20 ischemic heart disease without evidence of acute myocardial infarction and evaluated in terms of several parameters and its clinical significance. The results observed were as follows : 1) Serum IgE levels were propgressively elevated from the first hospital day(259+/-3IU/ml) up to peak level of the fifth hospital day(415+/-2IU/ml) and progressively lowered and returned to almost same level as the first hospital day on the twenty first hospital day. On the other hand control group showed significantly lower IgE levels throughout all hospital day and also did not showed serial change. 2) In the patient group with the initial serum IgE level above 200IU/m; showed significantly lower level of serum SGOT, CPK level than the group of below 200IU/ml group. This suggests the initial serum IgE level might have some correlation of the extent of myocardial necrosis. 3) In patients of acute myocardial infarction, ejection fraction was checked at discharge. Initial serum IgE level above 200IU/ml group showed significantly higher ejection fraction than below 200IU/ml group(59.4+/-13.5% vs 38.4+/-13.7%). 4) Serum IgE was checked concomittantly with serum IgE. It showed slightly decreasing tendency at third hospital day but not statistically significant. Eosinophil changed similar pattern as serum IgE but it was also not statistically significant. In conclusion, serial checking of serum IgE level in patient of acute myocardial infarction may give some help in prediction the clinical course and prognosis.
Aspartate Aminotransferases ; Eosinophils ; Hand ; Humans ; Immunoglobulin E* ; Immunoglobulin G ; Immunoglobulins* ; Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Necrosis ; Prognosis

PURPOSE: The purpose of this study was to test whether pre-operative visual information and parental presence had positive effects on anxiety, delirium, and pain in pediatric patients who awoke from general anesthesia in a post-surgical stage. METHODS: This study used a non equivalent control-group post test design (n=76). Independent variables were provision of pre-operative visual information and parental presence for post-surgical pediatric patients in PACU (post anesthesia care unit). Dependent variables were anxiety, delirium, and pain in the pediatric patients measured three times at 10 minute intervals after extubation in the PACU. Measurements included Numerical Rating Scale for assessing state anxiety, Pediatric Anesthesia Emergence Delirium Scale by Sikich & Lerman (2004) for delirium, and Objective Pain Scale by Broadman, Rice & Hannallah (1988) for pain. RESULTS: Experimental group showed significantly decreased state anxiety at time points-10, 20, and 30 minutes after extubation. Delirium was significantly lower at 10 minutes and 30 minutes after extubation in the experimental group. Pain was significantly lower at 10 minutes after extubation in the experimental group. CONCLUSION: The results of this study suggest that this intervention can be a safe pre-operative nursing intervention for post-surgical pediatric patients at PACU.
Adolescent ; Anesthesia Recovery Period ; Anesthesia, General ; *Anxiety ; Child ; *Delirium ; Female ; Humans ; Male ; *Pain ; *Pain Measurement ; Parents ; Patient Education as Topic ; Postanesthesia Nursing ; Preoperative Care ; Recovery Room