Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.
Acromioclavicular Joint ; Acromion* ; Clavicle* ; Dislocations ; Humans ; Joints ; Osteolysis ; Range of Motion, Articular ; Rotator Cuff ; Tears

No abstract available.
Muscle, Smooth* ; Smooth Muscle Tumor* ; Stomach*

No abstract available.
Hemodynamics* ; Hypertension, Pulmonary*

The 213 first ribs Koreans were measured and morphologically studied. The results were as follows. 1. On average, the internal straight length of the first rib was 53.7mm (male), 49.9mm (female) ; the external straight length was 79.7mm (male), 75.4mm (female), the maximum straight length was 87.4mm (male), 81.2mm (female) ; the breadth was 15.2mm (male), 14.4mm (female) ; and the thickness was 5.5mm (male), 5.4mm (female). 2. The proportion of the scalene tubercle to the costal breadth was 0% to 90% (average 37%). 3. The incidence of the presence of the groove for the first thoracic nerve was 7.5%. 4. The common shapes of the articular surface of the head were ball-shape(41%), cylinder-shape (25%) and plane-shape (25%) ; and those of the tubercle were cylinder-shape (44%), saddle-shape (31%) and socket-shape (14%).
Head ; Incidence ; Ribs* ; Thoracic Nerves

No abstract available.
DNA* ; Herpesvirus 3, Human*

Epidural clonidine is reported to produce analgesia in humans. To investigate the analgesic effect and prolongation of epidural and spinal anesthesia, we mixed 0.2mg epinephrine, 150 mcg clonidine, or 1 cc normal saline with 0.5% bupivacaine and compared the hemodynamie and analgesic effects of each drug. Heart rate and blood pressure were checked before, during and after anesthesia. Sensory level was checked by pin-prick method. The results were as follows; 1) The analgesia onset time and the time to highest level of sensory loss was most rapid in the epinephrine group. 2) The two segment regression time was significantly prolonged in the epinephrine group. 3) The analgesia duration was significantly prolonged in the clonidine and epinephrine group. 4) Although the heart rate gradually decreased over 60 min. After injection of each drug, there was no significant change between the groups. 5) Blood pressure decreased over 20-30 min. After injection of each drug, but there was no significant change between the groups.
Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Anesthesia, Spinal ; Blood Pressure ; Bupivacaine* ; Clonidine* ; Epinephrine* ; Heart Rate ; Humans

Forty patients with preeclampsia, undergoing general anesthesia for Cesarean section were studied. They were allocated randomly to receive either propofol 2.5 mg/kg and laryngeal mask insertion or thiopental sodium 4 mg/kg and endotracheal intubation for induction of anesthesia. All patients receiving thiopental sodium and tracheal intubation showed potentially dangerous reflex cardiovascular instability. There was a average 48.7 mmHg increase in systolic blood pressure after intubation. The patients receiving propofol and laryngeal mask insertion showed only 10.7 mmHg increase in systolic blood pressure. It is concluded that thiopental sodium induction and traeheal intubation of patients with preecalmpsia produces an increase in blood pressure which can lead to a risk of significant complication. Thus propofol induction and laryngeal mask seems to be a suitable anesthetic method in preeclampsia.
Anesthesia ; Anesthesia, General ; Blood Pressure ; Cesarean Section* ; Female ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngeal Masks* ; Pre-Eclampsia* ; Pregnancy ; Propofol* ; Reflex ; Thiopental

Deep skin and soft tissue defects with exposed bone and tendon is difficult to treat, because skin graft rarely survives and flap surgery is sacrifice of donor site. Since "Stage I" membrane was developed by Yannas and Bruke in 1980, numerous kinds of artificial skin have been developed. The adaptability of "Terudermis", developed by the Terumo Co., as an artificial skin composed of sponge made of a fibrillar atelocollagen and a heat-denatured atelocollagen, was clinically evaluated on application to 13 cases presenting deep skin and soft tissue defect with exposed bones and tendons from October 1997 to march 1998. Terudermis has the advantage of allowing early incorporation of fibroblasts and capillaries into its collagen sponge due to very weak dehydrothermal cross-linking. Before Terudermis graft, several days of wet dressing and debridement were required to prepare healthy well-vascularized bed because Terudermis was weak on unsanitary wounds. After bed preparation, Terudermis was grafted like usual skin graft. Tie-over bolster dressing or compressive dressing was used case by case. The dressing was opened 2~3 days after Terudermis grafting. Wet dressing was done daily until the skin graft was done. Autologous skin graft was done 2-3 weeks after Terudermis graft. Our clinical results indicated that Terudermis was beneficial in treating 77% of our patients. Through the use of this new method, treatment of severe skin and soft tissue defects that are usually treated by musculocutaneous or other conventional skin flaps can be replaced by Terudermis as an new artificial dermis.
Bandages ; Capillaries ; Collagen ; Debridement ; Dermis ; Fibroblasts ; Humans ; Membranes ; Porifera ; Skin ; Skin, Artificial ; Tendons ; Tissue Donors ; Transplants ; Wounds and Injuries*

The purpose of this study was to investigate the morphologic changes of the bile canaliculi and its associated structures of the liver induced by common bile duct ligation(CBDL) in the rat. The canalicular surface and lateral surface of the dry-fractured hepatocytes was studied with scanning electron microscopy at 1~6 weeks post ligation. The first week after CBDL, the bile canaliculi were dilated. The microvilli were increased in number and the lumens contained granular materials After 2 weeks or more, the bile canaliculi were dilated to a variable degree, and with irregularity, measuring from 1.5 to 5 micrometer in diameter, and in the advanced stage, the canaliculi showed blunting and the disappearance of microvilli. Some canaliculi had sprouting side branches. At 4~6 weeks post-ligation, the lateral surface of the hepatocytes also showed some irregularity and a tortuous appearance, and numerous small sized microvillous projections were formed. The tubular structures of the proliferated SER distributed adjacent to the lateral surface of the hepatocytes, and the direct connection of a tubular structure and the cytoplasmic membrane was observed. These results suggest that the deformity and loss of microvilli of bile canaliculi reflect the disturbance of bile secretion from the hepatocytes. And prolonged obstruction of bile flow may result in bile excretion via the lateral surface of hepatocytes.
Rats ; Animals

This study was carried out to find out specific proteins from different organs of Clonorchis sinensis. Crude extract, organ-specific and excretory-secretory (ES) proteins were analyzed by immunoblot with infected human sera. The bands of 7- and 17-kDa were main component of intestinal fluid and ES protein and commonly found in all organspecific proteins. The 17-kDa protein was observed from ES antigen, intestinal fluid, eggs and sperms, 26- and 28- kDa proteins were from the uterus, vitellaria, and ovary, and 34-, 37-, 43- and 50-kDa proteins were mainly from the testis and sperms. Serum of mice immunized with sperms reacted to the 50-kDa protein by immunoblotting and immunohistochemical staining showed a positive reaction at the seminal receptacle and seminiferous tubule. The present results show that the 7-kDa protein is a common antigen of every part or organ of C. sinensis, but different organs express their specific antigenic protein bands.
Animals ; Antigens, Helminth/*analysis ; Clonorchis sinensis/anatomy & histology/*immunology ; Female ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Rabbits ; Research Support, Non-U.S. Gov't