Humans ; Lymphohistiocytosis, Hemophagocytic ; diagnosis ; therapy

BACKGROUND: The purpose of this study is to compare clinical and radiological outcomes between trans-acromial fixation with Kirschner's wire (K-wire) and AO locking hook plate fixation for acute acromioclavicular (AC) joint dislocation. METHODS: This study included 61 patients who underwent either closed reduction and trans-acromial fixation with K-wire (group A, 23 patients) or open reduction and internal fixation with AO locking hook plate (group B, 38 patients). Pain on a visual analogue scale (VAS) score, the University of California Los Angeles (UCLA) shoulder score, the American Shoulder and Elbow Surgeons (ASES) score, and active range of motion (ROM) were used in the functional evaluation. For radiological evaluation, coracoclavicular distance (CCD) was measured on both clavicular anteroposterior view and compared between groups. RESULTS: At one-year follow-up, no significant differences in VAS pain score, UCLA shoulder score, ASES score, and active ROM were observed between groups, despite five cases (22.7%, 5/23) of complication in group A. The side-to-side difference between normal and affected CCD was 2.4 ± 2.2 mm in group A and 0.2 ± 0.7 mm in group B. This difference showed a statistical significance between groups (p<0.001). CONCLUSIONS: For the treatment of acute AC joint dislocation, the K-wire trans-acromial fixation group showed a significantly greater CCD than the AO locking hook plate group. In addition, during the follow-up period, much higher incidence of complication related to implant was observed in the trans-acromial fixation group. Although clinical outcomes between groups were not significantly different, these results should be interpreted carefully.
Acromioclavicular Joint* ; California ; Dislocations* ; Elbow ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Range of Motion, Articular ; Shoulder ; Surgeons

Adolescent ; Child ; Child, Preschool ; Clinical Trials as Topic ; Flow Cytometry ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunophenotyping ; Leukemia, Myeloid, Acute ; diagnosis ; pathology ; therapy ; Neoplasm, Residual ; diagnosis ; pathology ; therapy ; Polymerase Chain Reaction ; Prognosis ; Recurrence ; Sensitivity and Specificity

A UPLC method has been developed in the current investigation for simultaneous determination of nine chemical markers of Bletilla striata, 4-hydroxymethylphenyl beta-D-glucoside, blestroside, dactylorhin A, militarine, dihydrophenanthrene 5, gymnoside V, dihydrophenanthrene 1, benzylphenanthrene 3 and gymnosides IX. Separation was performed at 45 degrees C on an ACQUITY UPLC BEH C18 column (2.1 mm x 150 mm, 1.7 microm) with a gradient solvent system of acetonitrile-water as the mobile phase. The flow rate was 0.3 mL x min(-1), the detection wavelength was 280 nm. The results showed that the nine chemical markers could be well resolved and that in the selected linear range, all calibration curves of the nine chemical markers showed good linearity (r > or = 0.999 3). The recoveries (n = 6) were in the range of 98.15% - 102.2% and RSDs were between 2.1% - 3.6%. The data suggested that the developed UPLC-UV method had good reproducibility, robustness, and accuracy, which was suitable for the quality control of Bletilla striata. Applications of the method showed that the nine chemical markers had higher contents in the wild B. striata than in the cultivated ones.
Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; Magnoliopsida ; chemistry ; Rhizome ; chemistry

No abstract available.
Fibrin Tissue Adhesive* ; Fibrin* ; Rabbits* ; Wound Healing* ; Wounds and Injuries*

No abstract available.
Fibrin Tissue Adhesive* ; Fibrin* ; Rabbits* ; Wound Healing* ; Wounds and Injuries*

BACKGROUND: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. METHODS: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. RESULTS: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was 1.29 ± 1.71 mm and AHD was 9.71 ± 2.65 mm. In cuff tear group, the mean SOC was 3.15 ± 3.41 mm and AHD was 8.28 ± 1.76 mm. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). CONCLUSIONS: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.
Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Methods* ; Rotator Cuff ; Scapula ; Shoulder ; Tears

Spinal anesthesia has a rapid onset and requires small doses of local anesthenc to provide reliable surgical anesthesia and good muscular reiaxation but the disadvantages are the unpredictability of upper level of block, precipitous hypotension, inability to extend the block, and the risk of postdural puncture headache. A combined spinalepidural (CSE) technique can be used to reduce or eliminate some of the disadvantages of spinal and epidural anesthesia while preserving their activity. A combined spinalepidural block may combine the reliability of spinal block and the flexibility of epidural block while minimizing their drawbacks. CSE anesthesia was performed in the 19 patients scheduled for elective total knee arthroplasty. At first 17 G Tuohy needle was inserted L2-3 interspace, the epidual space would be identified, and then a long 22 G spinal needle was introduced through the Tuohy needle until the tip of the spinal needle would penetrate the dura. The correct placement of the spinal needle was confirmed by the appearence of cerebrospinal fluid at the head of needle, then 0.5% hyperbaric tetracaine 1.6-2 ml was injected into subarachnoid space. The spinal needle was withdrawn and a 18 G epidural catheter was introduced into the epidural space. If the patients complained pain during operation, 5 ml of 2% lidocaine was injected through epidural catheter, 2.5 mg Morphine was injected into epidural space for postoperative pain control after operation. Operations were well performed under CSE anesthesia and postoperative pain controls were well managed, too. The responses of the patients who has experienced CSE anesthesia were mostly good.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, Spinal ; Arthroplasty* ; Catheters ; Cerebrospinal Fluid ; Epidural Space ; Head ; Humans ; Hypotension ; Knee* ; Lidocaine ; Morphine ; Needles ; Pain, Postoperative ; Pliability ; Post-Dural Puncture Headache ; Subarachnoid Space ; Tetracaine

OBJECTIVE: This study was performed to compare the clinical response to controlled ovarian hyperstimulation (COH) of in vitro fertilization and embryo transfer (IVF-ET) according to the size of baseline ovarian cyst. METHOD: From February 1992 to March 1999, a retrospective analysis was done of 272 cases who underwent COH using mid-luteal phase long protocol of gonadotropin-releasing hormone agonist (GnRH-a) for IVF-ET. These cases were divided into four group; group 1 (n=63) had cysts with mean diameters between 20.2 and 29.0 mm on their baseline ultrasound on cycle day 3, group 2 (n=57, 30.0~49.0mm), group 3 (n=68, >50.0mm) and control group (n=84). Cases were excluded according to the following criteria; pure male factor infertility, the presence of only one ovary, high CA-125 level and previous endometriosis. RESULTS: There were no statistically significant differences between cases with baseline ovarian cyst <50.0 mm in diameter and control group in any of the parameters. However, cases with baseline ovarian cyst>50.0 mm in mean diameter needed more amount of human menopausal gonadotropin (hMG), showed significantly lower estradiol (E2) level, the number of follicle >15.0 mm on the day of human chorionic gonadotropin (hCG) administration, the number of oocytes retrieved, the number of mature oocytes, and pregnancy rate compared with control group. CONCLUSION: This study suggests that cases with baseline overian cyst <50.0 mm in diameter do not adversely impact on IVF-ET outcome. However, cases with baseline ovarian cyst >50.0 mm in diameter had adverse effects on various parameters. Therefore, to improve the outcome of IVF-ET in these cases, ovarian cyst aspiration prior to initiating COH may be required.
Chorionic Gonadotropin ; Embryo Transfer* ; Embryonic Structures* ; Endometriosis ; Estradiol ; Female ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Infertility ; Male ; Oocytes ; Ovarian Cysts* ; Ovary ; Pregnancy Rate ; Retrospective Studies ; Ultrasonography

No abstract available.
Emergencies* ; Emergency Medicine* ; Internship and Residency*