Fractures of the tibia are frequently encountered in mordern civilized society. Especially, those in distal 1/3 of the tibia have so many problems, such as angular deformity, osteomyelitis and nonunion because of anatomically scanty soft tissue. Many modalities of the treatment of fracture of distal 1/3 of the tibia were introduced. Among them, interlocking IM nailings were considered as one of the best modality. But, in interlocking IM nail, reaming of the medullary canal which destroys the endosteal circulation and causes thermal necrosis of the inner aspect of the cortical bone results in delayed union. And also, procedure for distal screw fixation is difficult and time-consuming. As for using flexible IM nails for fractures of distal 1/3 of the tibia, it was considered as not so satisfactory method due to lack of stability of fixation. However, the stability of fixation can be strengthened with fanning of the nails in distal fragment, using more than 3 nails and delay the protected weight bearing. Authors studied 25 cases of fractures of distal 1/3 of the tibia treated with closed flexible IM nailing at Sung Ae General Hospital, from July., 1987 to July., 1989, and obtained following results: 1. Among 25 cases, 4th decades were most common and males were more commonly involved. 2. Traffic accidents were the most common causes of injury and majority of 16 open fractures and 19 comminuted fractures, were caused by high energy mechanism. Among open fractures, type II were most common. 3. Two angular deformities less than 10 degrees, one proximal migration and one checkrein deformity were observed as complications, but, no clinically significant complications were noted. 4. The time for radiological union were 14.5 weeks in group without fibular fracture and 15.1 weeks in group with fibular fracture, and 14.0 weeks in closed fracture group and 17.2 weeks in open fracture group, and average in 15.6 weeks.
Accidents, Traffic ; Clinical Study ; Congenital Abnormalities ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Hospitals, General ; Humans ; Male ; Methods ; Necrosis ; Osteomyelitis ; Tibia ; Weight-Bearing

No abstract available.
Tracheoesophageal Fistula*

No abstract available.
Meconium* ; Peritonitis*

Nitric oxide (NO) is synthesized within the adult and developing kidney and plays a critical role in the regulation of renal hemodynamics and tubule function. In the adult kidney, the regulation of NO synthesis is very cell type specific and subject to distinct control mechanisms of NO synthase (NOS) isoforms. Endothelial NOS (eNOS) is expressed in the endothelial cells of glomeruli, peritubular capillaries, and vascular bundles. Neuronal NOS (nNOS) is expressed in the tubular epithelial cells of the macula densa and inner medullary collecting duct. Furthermore, in the immature kidney, the expression of eNOS and nNOS shows unique patterns distinct from that is observed in the adult. This review will summarize the localization and presumable function of NOS isoforms in the adult and developing kidney.
Adult* ; Capillaries ; Endothelial Cells ; Epithelial Cells ; Hemodynamics ; Humans ; Kidney* ; Neurons ; Nitric Oxide Synthase ; Nitric Oxide* ; Protein Isoforms

BACKGROUND/AIM: The lipo-PGE1, known for being more stable during pulmonary circulation and having more targeting effect, has been reported to inhibit ET-1 induced stellate cell contraction. We assessed the effect of lipo-PGE1 on the change of ET-1 concentration and the relationship between ET-1 concentration and the liver damage. METHODS: Mongrel dogs weighing about 25 kg were divided into a control (n=6) and a lipo-PGE1 (n=6) group. Partial liver allotransplantation was performed. In the lipo-PGE1 group, lipo-PGE1 was slowly infused through splenic venous cannulation during the donor liver harvesting procedure (50 microgram) and continuously infused (60 microgram/day) for 48 hours after reperfusion. The AST, ALP, LDH and ET-1 concentrations were monitored RESULTS: The AST and ALP levels of the lipo-PGE1 group were significantly lower than those of the control group both at 1 hour and 48 hours after reperfusion. The LDH level in the lipo-PGE1 group was lower at 1 hour and 48 hours after reperfusion. But there was no statistical difference between the two groups. The baseline ET-1 concentration of the lipo-PGE1 group was eight times higher than that of the control group. The ET-1 concentration was elevated gradually in the control group. There was no significant difference between the two groups at 48 hours. There was no correlation between ET-1 concentrations and AST, ALP, LDH levels. CONCLUSION: This study demonstrated the hepatoprotective effect of the lipo-PGE1 against ischemia-reperfusion injury in canine partial liver allotransplantation. However, the baseline ET-1 level was eight times higher in the lipo-PGE1 group than that of the control group in spite of the hepatoprotective effects of the lipo-PGE1.
Alprostadil* ; Animals ; Catheterization ; Dogs ; Endothelin-1* ; Humans ; Liver Transplantation* ; Liver* ; Pulmonary Circulation ; Reperfusion ; Reperfusion Injury* ; Tissue Donors

Castleman's disease is an atypical lymphoproliferative disorder of unknown origin. It has three histologic types (hyaline vascular, plasma-cell, and mixed) and two clinical types (localized and multicentric). Some systemic diseases may be accompanied with Castleman's disease, but it is unclear if Castleman's disease is relevant to rheumatoid arthritis. We experienced a case of Castleman's disease suffering from rheumatoid arthritis. A 25-year-old female with rheumatoid arthritis was referred to our hospital with a palpable mass lesion in the left upper arm. Excisional biopsy of the mass and arthroscopic synovectomy were performed, and the histological finding was compatible with hyaline-vascular type of Castleman's disease. Herein, we report this case along with brief review of relevant literature.
Arm ; Arthritis, Rheumatoid ; Biopsy ; Female ; Giant Lymph Node Hyperplasia ; Humans ; Lymphoproliferative Disorders ; Stress, Psychological

To evaluate a new reliable sclerosant of the gallbladder, we attempted gallbladder ablation with 10% phenol, and the results compared with those from using 95% ethanol which had been used previousy as gallbladder sclerosing agent in laboratory animals in other reports. After laparotomy, ligation of the cystic dusts with silk and cannulation of gallbladder with 18 gauge angiocatheter were done. Then, transcatheter administration of two different scleroing agents was performed in 8 rabbits respectively and normal saline in four rabbits as a control. Additionally, preliminary washing with each agent were implemented to prevent the dilutional effect of residual bile and bleeding. All animals survived without complication. Eight animals were used for each agent, four each being sacrified two weeks and six weeks after adminstration of sclerosing agents respectively. In our results, 10% phenol was more effective than 95% ethanol in denuding the gallbladder epithelium and promoting fibrosis of gallbladder wall, And it was relatively safe in regard to the dilutional effect of residual fluid and bleeding during procedure. Toxic effects on the liver evaluated by examination of histologic specimen were non-specific except for edematous swelling on some cases, which had also been observed on others including control group. 10% phenol can be considered to be a promosing sclerosant for gallbladder ablation, but further study of its toxicity is needed before its application on human gallbladder.
Animals ; Animals, Laboratory ; Bile ; Catheterization ; Dust ; Epithelium ; Ethanol ; Fibrosis ; Gallbladder* ; Hemorrhage ; Humans ; Laparotomy ; Ligation ; Liver ; Phenol* ; Rabbits* ; Sclerosing Solutions ; Sclerosis* ; Silk

We present the case report of a 72-year-old female in whom diaphragmatic eventration and secondary gastric volvulus developed 10 years after a left partial pneumonectomy for a bronchiectasis. Eventration of the diaphragm is defined as an abnormal elevation of an intact diaphragm. The abnormally wide subdiaphragmatic space provides the potential for a gastric volvulus, which results from the strong negative intrathoracic pulling force created by the potential subphrenic space and paradoxical movement of the diaphragm. Unless this strong negative force is first eliminated, gastropexy alone will lead to recurrence. Obliteration of the subphrenic space by colonic displacement is a simple and effective way of abolishing this negative subdiaphragmatic pulling force. Treatment of gastric volvulus requires immediate surgical repair to prevent subsequent necrosis and perforation, with surgical correction of the underlying anatomic abnormality being the treatment of choice for gastric volvulus. We experienced a case of gastric volvulus due to diaphragmatic eventration who was treated with colonic displacement.
Aged ; Bronchiectasis ; Colon ; Diaphragm ; Diaphragmatic Eventration ; Displacement (Psychology) ; Female ; Gastropexy ; Humans ; Necrosis ; Pneumonectomy ; Recurrence ; Stomach Volvulus

E-cadherin is a cell adhesion molecule that plays an important role in maintaining renal epithelial polarity and integrity. The purpose of this study was to determine the exact cellular localization of E-cadherin in pig kidney. Kidney tissues from pigs were processed for light and electron microscopy immunocytochemistry, and immunoblot analysis. E-cadhedrin bands of the same size were detected by immunoblot of samples from rat and pig kidneys. In pig kidney, strong E-cadherin expression was observed in the basolateral plasma membrane of the tubular epithelial cells. E-cadherin immunolabeling was not detected in glomeruli or blood vessels of pig kidney. Double-labeling results demonstrated that E-cadherin was expressed in the calbindin D28k-positive distal convoluted tubule and H(+)-ATPase-positive collecting duct, but not in the aquaporin 1-positive, N-cadherin-positive proximal tubule. In contrast to rat, E-cadherin immunoreactivity was not expressed at detectable levels in the Tamm-Horsfall protein-positive thick ascending limb of pig kidney. Immunoelectron microscopy confirmed that E-cadherin was localized in both the lateral membranes and basal infoldings of the collecting duct. These results suggest that E-cadherin may be a critical adhesion molecule in the distal convoluted tubule and collecting duct cells of pig kidney.
Animals ; Blotting, Western/veterinary ; Cadherins/*genetics/metabolism ; Cell Membrane/*metabolism/ultrastructure ; *Gene Expression Regulation ; Kidney/*metabolism ; Male ; Microscopy, Electron, Transmission/veterinary ; Sus scrofa/*genetics/metabolism

The incidence of ectopic pregnancy is increased since IVF-ET has started. The risk factors for ectopic pregnancy after assisted reproductive techniques are tubal abnormality, previous myomectomy, the number of transfered embryo, the technical aspects of embryo transfer, the amount of transfered medium and uterine reverse contraction after embryo transfer. Because of the possibility of combined pregnancy after IVF-ET, bilateral adnexal area should be examined by transvaginal ultrasonography at searching intrauterine gestational sac and also serial beta-hCG levels should be checked. We report a case of simultaneous left tubal and right ovarian pregnancies after IVF-ET with a brief review of literature.
Embryo Transfer ; Embryonic Structures ; Female ; Gestational Sac ; Incidence ; Pregnancy ; Pregnancy, Ectopic* ; Reproductive Techniques, Assisted ; Risk Factors ; Ultrasonography