There is still discussion concerning the methods for treating Tossy type 3 dislocations of the acromioclavicular joint. Since 1995, the authors have treated 10 patients of type 3 dislocations by arthroscope-assisted modified Weaver and Dunn operation with favorable results. The operation consisted of diagnostic shoulder arthroscopy, arthroscopic resection of acromial end of coracoacromial ligament with bone block, excision of distal end of clavicle, bone block transfer of coracoacromial ligament into the medullary canal of clavicle, and augmentation between coracoid process and resected distal end of clavicle with the Mersilene tape. The advantages of this arthroscope-assisted modified Weaver and Dunn operation are as follows: (1) Using the shoulder arthroscope, associated patholgy in the shoulder joint can be found and treated appropriately. (2) Arthroscopic resection of the acromial end of coracoacromial ligament can give the small incision and least damage to the deltoid muscle so that immediate post-operative range of motion exercise can be possible. (3) Bone block transfer of coracoacromial ligament and augmentation between coracoid process and resected clavicular end can prevent displacement of the resected clavicular end.
Acromioclavicular Joint ; Arthroscopes* ; Arthroscopy ; Clavicle ; Deltoid Muscle ; Dislocations* ; Humans ; Ligaments ; Range of Motion, Articular ; Shoulder ; Shoulder Joint

No abstract available.
Child* ; Cholecystectomy, Laparoscopic* ; Humans

No abstract available.
Gastroschisis*

PURPOSE: To investigate the characteristics of the limbal epithelial cells auto-cultivated in vivo on amniotic membrane (LIVAMs) designed for the treatment of limbal stem cell deficiency. METHODS: We removed the epithelium of AM with a No.15 blade after it was blotted with 20% ethanol and made a 360 degrees stromal flap along the epithelial defect. We then mounted over-sized AM (1 mm larger in diameter than the defect) over the defect with the border of AM inserted under the flap, and performed interrupted suture with 10-0 nylon. A therapeutic contact lens was fitted over the AM and a temporary tarsorrhaphy was performed. To examine whether the limbal epithelial cells grew well onto AM, we observed the cornea after fluorescein dye staining using a slit lamp. To explore the characteristics of LIVAMs, we performed hematoxylin-eosin (H&E) staining, immunochemical staining with AK-2, AE-5, AM-3 monoclonal antibodies, and transmission electron microscopy. RESULTS: Three of four rabbits had successful epithelial growth on the amniotic membrane. The epithelial growth on the amniotic membrane was stained using immunohistochemical staining (AK-2, AE-5). Electron microscopy showed a structure similar to that of a normal corneal epithelium. CONCLUSIONS: The technique of auto-cultivation of limbal epithelial cells in vivo on amniotic membrane can be an efficient and convenient method and preserves the characteristics of limbal epithelial cells for the treatment of limbal stem cell deficiency.
Amnion* ; Antibodies, Monoclonal ; Cornea ; Epithelial Cells* ; Epithelium ; Epithelium, Corneal ; Ethanol ; Fluorescein ; Microscopy, Electron ; Microscopy, Electron, Transmission ; Nylons ; Rabbits* ; Stem Cells ; Sutures

No abstract available.
Humans ; Psoriasis* ; Siblings*

OBJECTIVES: Homocysteine has been associated with cognitive impairment and various psychiatric symptoms. This study was designed to examine the relationship exists between plasma homocysteine concentration and behavioral and psychological symptoms of dementia(BPSD). METHODS: 41 subjects with dementia of Alzheimer's type were included in this study. We carried out history taking, physical examination, and cognitive assessment for the diagnosis of dementia of Alzheimer's type based on DSM-IV. We scored the Mini Mental State Examination(MMSE), Global Deterioration Scale(GDS), Clinical Dementia Rating(CDR), and the Korean Neuropsychiatric Inventory(K-NPI). We also measured levels of homocysteine, folate, and vitamin B12 in the plasma. RESULTS: We found statistically significant positive correlations between homocysteine concentration with NPI total score, and with scores of several sub-domains such as delusion, agitation/aggression, depression/dysphoria, and elation/euphoria. No significant correlation existed between homocysteine levels and scores of MMSE, GDS, and CDR. CONCLUSIONS: This study shows that plasma homocysteine levels are associated with BPSD. Further research is necessary to identify pathophysiologic mechanisms underlying these relationships.
Delusions ; Dementia* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Folic Acid ; Homocysteine* ; Humans ; Physical Examination ; Plasma ; Vitamin B 12

Intradural lumbar disc herniation is a rare disease. According to the reports of intradural lumbar disc herniations, most cases have developed as a chronic degenerative disc diseases. Traumatic intradural lumbar disc herniations are even rarer. A 52-year-old man visited our emergency center with numbness in his left calf and ankle after falling accident. Initial impression by radiologic findings was a spinal subdural hematoma at the L1 level. A follow up image two weeks later, however, did not demonstrate any interval change. The patient was decided to have an operation. In operative findings, a ruptured disc particle penetrating the ventral and dorsal dura was indentified after laminectomy. It was assumed to be a traumatic outcome not a degenerative change.
Ankle ; Emergencies ; Follow-Up Studies ; Hematoma, Subdural ; Hematoma, Subdural, Spinal ; Humans ; Hypesthesia ; Laminectomy ; Middle Aged ; Rare Diseases

BACKGROUND: The purposes of this study are to determine the prevalence of malnutrtion and its trend of change and to establish its relationship with dysphagia and functional outcome in rehabilitation patients. METHOD: We included 39 patients who were admitted into rehabilitation ward, and we evaluated nutri- tional parameters(serum albumin, serum lymphocyte, and weight loss) and dysphagia at the time of admi- ssion and four weeks after admission. We analyzed total rehabilitation inpatients and stroke patients who were major inpatients of rehabilitation ward. We measured Functional Independence Measure(FIM) and length of stay as clinical outcome scales. RESULTS: Malnutrition was observed in 76.9% of total patients and 69.6% in stroke patients at the time of admission. After four weeks, malnutrition was observed in 65.4% and 66.7%, respectively. Prevalence of dysphagia was 25.0% in non-malnourished patients and 22.0% in malnourished patients at the time of admission. It was not changed significantly after four weeks of rehabilitation. The length of stay was 31.3+/-16.0 days in non-malnourished patients and 39.8+/-19.4 days in malnourished patients. The FIM effi- ciency was 1.0+/-0.6 in non-malnourished patients and 2.3+/-6.5 in malnourished patients. CONCLUSION: Our findings suggest that malnutrition was highly prevalent in rehabilitation inpatients and it did not improved significantly through four weeks of rehabilitation. Therefore, it is important to be concerned about malnutrition and it needs proper and active management.
Deglutition Disorders ; Humans ; Inpatients* ; Length of Stay ; Lymphocytes ; Malnutrition* ; Prevalence ; Rehabilitation* ; Serum Albumin ; Stroke ; Weights and Measures

No Abstract Available.
Chondrocytes* ; Phenotype*

BACKGROUND: The goal of this study was to evaluate whether a modified fluoroscopic technique for positioning a hook plate affected the clinical results of treating Neer type II distal clavicle fractures and Rockwood type V acromioclavicular (AC) joint separations with this device. METHODS: The study was a retrospective consecutive case series with data analysis. Sixty-four patients with a Neer type II distal clavicle fracture or a Rockwood type V AC joint injury treated between March 2009 and June 2013 were divided into 2 groups: traditional fluoroscopic technique (traditional view, 31 patients) or modified fluoroscopic technique ('hook' view, 33 patients). A visual analogue scale (VAS) score, the modified University of California-Los Angeles (UCLA) shoulder scale score, and radiographic osteolysis were the main outcome measures. RESULTS: The traditional group included a significantly larger number of patients with acromial osteolysis than the hook view group: 23 patients (74.2%) vs. 11 patients (33.3%), respectively (p=0.01). Before plate removal, the hook group reported less pain and higher UCLA shoulder scale scores than the traditional group: average VAS score, 1.55 vs. 2.26, respectively; average UCLA score, 30.88 vs. 27.06, respectively. However, there was no significant difference after plate removal. CONCLUSIONS: The hook view allows more accurate bending of the hook plate around the contour of the acromion, resulting in decreased osteolysis, decreased pain, and better function with the plate in situ.
Acromioclavicular Joint ; Acromion ; Clavicle* ; Dislocations ; Humans ; Joints ; Osteolysis ; Outcome Assessment (Health Care) ; Retrospective Studies ; Shoulder ; Statistics as Topic