STUDY DESIGN: A randomized, controlled animal study. PURPOSE: To investigate the effectiveness of fusion and new bone formation induced by demineralized bone matrix (DBM) strips with jelly strengths. OVERVIEW OF LITERATURE: The form of the DBM can make a difference to the outcome. The effect of different jelly strengths on the ability of DBM to form new bone is not known. METHODS: Forty-eight rabbits were randomized into a control group and two experimental groups. In the control group (group 1), 1.4 g of autologous iliac crest bone was placed bilaterally. In the experimental groups, a high jelly strength DBM-hyaluronic acid (HA)-gelatin strip (group 2) and a low jelly strength DBM-HA-gelatin strip (group 3) were used. The fusion was assessed with manual manipulation and radiographs. The volume of the fusion mass was determined from computed tomographic images. RESULTS: The fusion rates as determined by manual palpation were 37.5%, 93.8% and 50.0% in group 1, group 2, and group 3, respectively (p<0.05). By radiography, the fusion rate of High jelly strength DBM strip was statistically significantly greater than that of the other alternatives (p<0.05). The mean bone volume of the fusion mass as determined by computed tomography was 2,142.2+/-318.5 mm3, 3,132.9+/-632.1 mm3, and 2,741.5+/-380.4 mm3 in group 1, group 2, and group 3, respectively (p<0.05). CONCLUSIONS: These results indicate that differences in the structural and mechanical properties of gelatin that are associated with jelly strength influenced cellular responses such as cell viability and bony tissue ingrowth, facilitating greater bone fusion around high jelly strength implants.
Animals ; Bone Matrix* ; Cell Survival ; Gelatin ; Osteogenesis ; Palpation ; Rabbits ; Radiography ; Spinal Fusion

No abstract available.
Pyoderma Gangrenosum* ; Pyoderma* ; Ulcer*

STUDY DESIGN: An experimental animal study. OBJECTIVES: To create a more appropriate disc degeneration model which shows how Interleukin 1alpha may induce the activation of metalloproteinases within the nucleus pulposus. SUMMARY OF LITERATURE REVIEW: There are few disc degeneration models wherein there is activation of metalloproteinases within the nucleus pulposus without structural destruction of the intervertebral disc. MATERIALS AND METHODS: Three consecutive intervertebral discs in New Zealand White Rabbits were exposed. Each disc was injected with 0.1ml of saline (Saline group), 0.1ml of 1microg/ml (IL-1 group), 0.1ml of 10microg/ml (IL-10 group) of IL-1alpha through a 30-gauge needle. The lumbar spine was harvested 12 weeks after operation. We then analyzed radiographic findings and histological changes. RESULTS: There was no difference in the radiological disc height index among the three groups; 0.071 in saline group, 0.045 in IL-1 group and 0.058 in IL-10 group (p=0.194). The histological cellularity of the nucleus pulposus revealed a decrease in the number of cells (p=0.0001, 1.42 in saline group vs. 3.00 in IL-10 group; p=0.001, 2.00 in IL-1 group and 3.00 in IL-10). The histological matrix of the nucleus pulposus was 1.42 in saline group and 2.42 in IL-10(p=0.007), which meant that there had been condensation of the extracellular nucleus pulposus matrix. CONCLUSIONS: The results of this study demonstrate that interleukin-1alpha may contribute to degradation of the nucleus pulposus. This is useful for future study into the effects of the cytokine inhibitor on matrix regeneration and cellularity in the nucleus pulposus in intervertebral disc disease.
Animals ; European Continental Ancestry Group ; Humans ; Interleukin-1 ; Interleukin-10 ; Interleukin-1alpha ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement ; Metalloproteases ; Needles ; Rabbits ; Regeneration ; Spine

PURPOSE: To report the clinical outcome of polyaxial locking plate (Noncontact bridging (NCB) plate (Zimmer, Warsaw, Indiana)) for the treatment of distal femur fracture with minimal invasive percutaneous periosteal osteosynthsis (MIPPO) technique. MATERIALS AND METHODS: Between February 2008 to April 2010, twenty six patients (11 men, 15 women), twenty eight cases diagnosed as distal femoral fractures are enrolled in this retrospective study. The mean age of the patients was 63 years (34 to 85) and the mean follow-up was 20.3 months (12 to 32). According to the AO/ASIF classification, 15 fractures were type A, 1 type B and 9 type C. And there were 3 periprsthetic fractures around knee. The analysis of the clinical and radiologic outcome were performed by Sanders functional evaluation scale and radiologic follow up after operation, respectively. RESULTS: Among 28 cases, 25 cases united without additional operation. According to Sanders functional evaluation scale, there were 11 excellent, 9 good, 4 fair, 2 poor. As complications, there were 1 knee stiffness, 1 delayed union, 1 implant failure with refracture, 1 implant loosening. Three patients except one knee stiffness, underwent a second LISS plating using NCB plate and and bone grafting, resulting in a satisfactory final outcome. CONCLUSION: Internal fixation using polyaxial locking plate with MIPO technique may be one of the most effective methods for the treatment of distal femoral fractures.
Bone Transplantation ; Femoral Fractures ; Femur ; Follow-Up Studies ; Humans ; Knee ; Male ; Retrospective Studies

PURPOSE: With growing interest in early imaging, the aim of our study was to define the most practical modality for routine clinical use for the diagnosis of acute pyelonephritis (APN). We compared the sensitivity of enhanced computerized tomography (CT), dimercaptosuccinic acid (DMSA) scintigraphy, and Doppler ultrasonography (DUS) by using clinical findings as the standard of reference. MATERIALS AND METHODS: A total of 207 APN patients (191 women, 16 men; mean age, 49.4 years; range, 17-88 years) were enrolled in this study. All the patients underwent imaging modalities during hospitalization. SPECT images were obtained 4 hours after injection of (99m)Tc-DMSA. Transverse and coronary CT images were obtained before and after injection of the contrast agent. DUS was performed in the longitudinal, transverse, and coronal planes. All the images were read independently by a single radiologist and a nuclear medicine specialist. The sensitivity of each modality for detecting APN was compared. RESULTS: CT showed significantly superior sensitivity compared with that of DUS (81.0% vs. 33.3%, respectively, n=147). DMSA scintigraphy also showed significantly superior sensitivity compared with that of DUS (74.7% vs. 33.3%, respectively, n=150). Compared with DMSA scintigraphy, CT showed superior sensitivity, but the difference was not statistically significant (81.0% vs. 74.8%, respectively, n=147, p=0.163). CONCLUSIONS: For cases of clinically suspected APN, CT and DMSA scintigraphy appear to be equally sensitive and reliable for detecting APN, although CT is more practical in various fields. DUS was significantly less sensitive.
Diagnostic Imaging ; Female ; Hospitalization ; Humans ; Nuclear Medicine ; Pyelonephritis ; Specialization ; Succimer ; Tomography, Emission-Computed, Single-Photon ; Ultrasonography, Doppler

Inflammatory myofibroblastic tumors (IMTs) are solid neoplastic mesenchymal proliferations composed of myofibroblastic spindle cells admixed with inflammatory infiltrates. The documented sites in the gastrointestinal tract include the esophagus, small intestine, colon, appendix, rectum, pancreas, spleen, liver, and Meckel's diverticulum. Biliary IMTs are rare, and IMTs arising from the ampulla of Vater have not been reported previously. Herein we report the case of a 65-year-old woman with an extrahepatic biliary obstruction due to IMT of the ampulla of Vater, and a successful therapeutic approach using endoscopic ultrasonography and endoscopic papillectomy.
Aged ; Ampulla of Vater ; Appendix ; Colon ; Endosonography ; Esophagus ; Female ; Gastrointestinal Tract ; Humans ; Intestine, Small ; Liver ; Meckel Diverticulum ; Myofibroblasts ; Pancreas ; Rectum ; Spleen

PURPOSE: Specific immunoglobulin G4 (sIgG4) and immunoglobulin E (IgE)-blocking factors produced by subcutaneous immunotherapy (SCIT) play a critical role in the induction of allergen tolerance. However, comparative studies of available SCIT reagents on the induction of sIgG4 are limited. We compared increases in sIgG4 for three different house dust mite (HDM) SCIT reagents. MATERIALS AND METHODS: Seventy-two HDM sensitized allergic patients were enrolled and classified into four groups: 1) control (n=27), 2) SCIT with Hollister-Stier® (n=19), 3) Tyrosine S® (n=16), and 4) Novo-Helisen® (n=10). Levels of specific IgE (sIgE), sIgG4, and IgE blocking factor to Dermatophagoides farinae (D. farinae) were measured using ImmunoCAP (sIgE, sIgG4) and enzyme-linked immunosorbent assay (ELISA) (IgE-blocking factors). Levels were measured before and 13.9±6.6 months after the SCIT. The allergen specificity and the induction levels of sIgE and sIgG4 were confirmed by immunoblot analysis. RESULTS: After SCIT, sIgG4 levels to D. farinae increased significantly; however, the increases differed significantly among the SCIT groups (p<0.001). Specific IgG4 levels to D. farinae were highest in Hollister-Stier® (3.7±4.1 mg/L), followed by Novo-Helisen® (2.2±2.3 mg/L) and Tyrosine S® (0.7±0.5 mg/L). In addition, patients who were administered using Hollister-Stier® showed the most significant decrease in IgE/IgG4 ratio (p<0.001) and increase in blocking factor (p=0.009). Finally, according to IgE immunoblot results, the Hollister-Stier® group showed the most significant attenuation of IgE binding patterns among others. CONCLUSION: Currently available SCIT reagents induce different levels of specific IgG4, IgE/IgG4 ratio, and IgE-blocking factor.
Dermatophagoides farinae ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulins* ; Immunotherapy* ; Indicators and Reagents ; Mites* ; Pyroglyphidae ; Sensitivity and Specificity ; Tyrosine

PURPOSE: Specific immunoglobulin G4 (sIgG4) and immunoglobulin E (IgE)-blocking factors produced by subcutaneous immunotherapy (SCIT) play a critical role in the induction of allergen tolerance. However, comparative studies of available SCIT reagents on the induction of sIgG4 are limited. We compared increases in sIgG4 for three different house dust mite (HDM) SCIT reagents. MATERIALS AND METHODS: Seventy-two HDM sensitized allergic patients were enrolled and classified into four groups: 1) control (n=27), 2) SCIT with Hollister-Stier® (n=19), 3) Tyrosine S® (n=16), and 4) Novo-Helisen® (n=10). Levels of specific IgE (sIgE), sIgG4, and IgE blocking factor to Dermatophagoides farinae (D. farinae) were measured using ImmunoCAP (sIgE, sIgG4) and enzyme-linked immunosorbent assay (ELISA) (IgE-blocking factors). Levels were measured before and 13.9±6.6 months after the SCIT. The allergen specificity and the induction levels of sIgE and sIgG4 were confirmed by immunoblot analysis. RESULTS: After SCIT, sIgG4 levels to D. farinae increased significantly; however, the increases differed significantly among the SCIT groups (p<0.001). Specific IgG4 levels to D. farinae were highest in Hollister-Stier® (3.7±4.1 mg/L), followed by Novo-Helisen® (2.2±2.3 mg/L) and Tyrosine S® (0.7±0.5 mg/L). In addition, patients who were administered using Hollister-Stier® showed the most significant decrease in IgE/IgG4 ratio (p<0.001) and increase in blocking factor (p=0.009). Finally, according to IgE immunoblot results, the Hollister-Stier® group showed the most significant attenuation of IgE binding patterns among others. CONCLUSION: Currently available SCIT reagents induce different levels of specific IgG4, IgE/IgG4 ratio, and IgE-blocking factor.
Dermatophagoides farinae ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulins* ; Immunotherapy* ; Indicators and Reagents ; Mites* ; Pyroglyphidae ; Sensitivity and Specificity ; Tyrosine

Objective: To investigate the effect of Opuntia humifusa aqueous extract on gastric ulcers. Methods: An ethanol-induced model was used to examine the protective effect of Opuntia humifusa against gastric ulcers. The gastric ulcer index was evaluated via clinical observation and image analysis. Various inflammatory indicators were determined by RT-PCR and Western blotting assays. Results: The gastric ulcer index was reduced to 8% in the group treated with Opuntia humifusa aqueous extract compared with that in the control group. RT-PCR analysis revealed that MUC5AC expression was reduced to 39% in the control group compared with the non-treated group, whereas the omeprazole and Opuntia humifusa aqueous extract-treated groups increased the expression to 95% and 79%, respectively. Moreover, the expressions of various cytokines including TNF-α, IL-1β, and IL-6 were increased in the control group, while decreasing in Opuntia humifusa aqueous extract-treated group. Opuntia humifusa aqueous extract also suppressed the expressions of iNOS, COX-2, and its transcription factor NF-κB and increased mucus content considerably as compared to the control group. Conclusions: These results suggest that Opuntia humifusa aqueous extract is suitable as an alternative remedy for gastric ulcer treatment.

PURPOSE: Pathogenically, both erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) are closely related to vascular problems, and vascular problems are closely associated with obesity. This study evaluated the relationships between obesity, BPH, and ED. MATERIALS AND METHODS: The medical history of male patients, aged > or =40 years, evaluated at urology outpatient clinics of 11 university hospitals in Korea with chief complaints of lower urinary tract symptoms (LUTS)/BPH and ED were retrospectively evaluated. The correlations of medical history, body mass index (BMI), international prostate symptom score (IPSS), prostate volume, International Index of Erectile Function -5 (IIEF-5), and serum testosterone level were assessed. RESULTS: Body mass index showed significant correlations with IPSS (r=0.087, p=0.003), prostate volume (r=0.384, p<0.001), IIEF (r=-0.072, p=0.015), and serum testosterone concentration (r=-0.303, p<0.001). CONCLUSIONS: Body mass index correlates with testosterone concentration, prostate volume, and markers of LUTS and ED in men with the latter conditions.
Ambulatory Care Facilities ; Body Mass Index ; Erectile Dysfunction* ; Hospitals, University ; Humans ; Korea* ; Lower Urinary Tract Symptoms ; Male ; Obesity* ; Prostate ; Prostatic Hyperplasia* ; Retrospective Studies ; Testosterone ; Urology