No abstract available.
Vascular Endothelial Growth Factor A*

STUDY DESIGN: Retrospective study. PURPOSE: This study was conducted to compare vertebral body height restoration rate in rheumatoid arthritis (RA) patients who had undergone percutaneous balloon kyphoplasty (KP) with that of control group who had matched age, sex, body mass index, and bone mineral density. OVERVIEW OF LITERATURE: There is no report on result of KP in RA patients. METHODS: Postoperative height restoration rate of RA group consisting of 15 patients (18 vertebral bodies) who had undergone KP due to osteoporotic vertebral compression fracture with a 30% or higher vertebral compression rate between May 2005 and January 2013 were compared to control group consisting of 38 patients (39 vertebral bodies) who had matched age, sex, body mass index, and bone mineral density. RESULTS: No statically significant difference in age (p=0.846), sex (p=0.366), body mass index (p=0.826), bone mineral density (p=0.349), time to surgery (p=0.528), polymethylmethacrylate injection time (p=0.298), or amount (p=0.830) was found between the RA group and the control group. However, preoperative compression rate in the RA group was significantly (p=0.025) higher compared to that in the control group. In addition, postoperative height restoration rate showed significant correlation with the RA group (p=0.008). Although higher incidence of recollapse occurred in the RA group compared to that in the control group, the difference was not statistically significant (p=0.305). CONCLUSIONS: Compared to the control group, RA patients showed higher compression rate and higher vertebral restoration rate after KP, indirectly indicating weaker bone quality in patients with RA. Higher incidence of recollapse occurred in the RA group compared to that in the control group, although it was not statistically significant.
Arthritis, Rheumatoid ; Body Height ; Body Mass Index ; Bone Density ; Fractures, Compression* ; Humans ; Incidence ; Kyphoplasty* ; Polymethyl Methacrylate ; Retrospective Studies

Congenital lobar emphysema has the clinical features of an air block' syndrome with- out the evidence of pulmonary infection or intrabronchial foreign body. The hyperinflated lung causes a compression of uninvolved lobes creating respiratory distress, cyanosis within the first weeks of life. We experienced a case of congenital lobar emphysema diagnosed incidentally by chest reontgenogram in an infant with frequent upper respiratory infection within a few weeks of life. Chest X-ray revealed extensive emphysematous changes in the left upper lobe, shifting of heart and medistinum to the right and compression of the right lung. Respiratory distress, cyanosis and chest wall retraction ensued and left upper lobe Lobectomy was performed successfully.
Cyanosis ; Emphysema* ; Foreign Bodies ; Heart ; Humans ; Infant ; Lung ; Thoracic Wall ; Thorax

No abstract available.
Endometrial Neoplasms* ; Female

The wound healing in adult mammals is a complex process that inevitably leaves scar. Various treatment modalities have been investigated to minimize the scar formation, and a few of them succeeded. Intra-lesional injection of steroids is one of the methods that have been widely accepted for the treatment of specific scars such as keloids or hypertrophic scars. On the other hand, there have been some attempts made to reduce the scar by enhancing the expression of matrix metalloproteinase(MMPs) because it results in degradation of collagens in scar tissues. Verapamil, a calcium channel blocker, was one of the few factors promoting the expression of MMPs such as collagenases by altering the shape of fibroblasts from a bipolar spindle type to a round one. No investigation, however, has been done to elucidate the effect of simultaneous intra- lesional injection of steroid and verapamil to wounds on early scar formation. To investigate the effect of scar reduction by injecting steroid and verapamil simultaneously, we examined morphologic finding of tissue and we measured width of scar followed by incision wounds treated with normal saline(Control group), steroid(Group A), verapamil(Group B) and both steroid and verapamil (Group C), respectively. The scar width significantly reduced in Group B and Group C 2 and 4 weeks after the incision and in Group A 8 weeks after incision, in comparison with control group. At that time the scar width in Group C significant reduced compared to those of other groups. Furthermore the collagen fibers were less, thicker and more regularly arranged in the scar tissue in group C 8 weeks after incision than those in the other groups and their structure was most close to the normal one of the dermis. The contour of fibroblasts in Group B and Group C looked rounder than that in Group A and control group. In conclusion, simultaneous intra-lesional injection of steroid and verapamil decreases collagen deposition into the wound and subsequently minimize scar width.
Adult ; Animals ; Calcium Channels ; Cicatrix* ; Cicatrix, Hypertrophic ; Collagen ; Collagenases ; Dermis ; Fibroblasts ; Hand ; Humans ; Keloid ; Mammals ; Matrix Metalloproteinases ; Rats* ; Steroids ; Verapamil* ; Wound Healing ; Wounds and Injuries*

PURPOSE: To investigate the accuracy and reproducibility of Optical Low Coherence Reflectometry (OLCR) corneal thickness measurements compared with the Orbscan system and ultrasound pachymeter (IOPac, Mentor). METHODS: Two examiners measured corneal thicknesses of 78 normal eyes and in 36 eyes that had undergone LASIK, and five sequential measurements of corneal thickness with OLCR, Orbscan system, Mentor, and IOPac were performed. Remeasurements of corneal thickness in 24 normal eyes were performed after two days to investigate intra-examiner reproducibility. RESULTS: The average corneal thickness measured in normal subjects was 536.3+/-23.8 micrometer in OLCR, 542.4+/-25.3 micrometer in the Orbscan system, 535.4+/-23.7 micrometer in Mentor, and 534.2+/-24.1 micrometer in IOPac. The average corneal thickness measured in patients who had undergone LASIK was 487.3+/-30.8 micrometer in OLCR, 492.5+/-36.5 micrometer in the Orbscan system, 487.5+/-30.8 micrometer in Mentor, and 485.3+/-30.8 micrometer in IOPac. There was no statistically significant difference between the four pachymeters. The inter-examiner and intra-examiner reproducibilities were shown to be highly reliable. CONCLUSIONS: The OLCR showed similar measurments of corneal thickness with the Orbscan system and ultrasound pachymeter, and showed no difference in reproducibility with different examiners.
Corneal Pachymetry* ; Humans ; Keratomileusis, Laser In Situ ; Mentors ; Ultrasonography*

BACKGROUND: It is important to differentiate between schwannomas and neurofibromas for the cases in which the histopathologic features overlap. Depending on the tumor type, surgeons can decide on a treatment method and whether to preserve or sacrifice the nerve; the possibility of malignant transformation in the case of neurofibromas also needs to be considered. METHODS: We studied 101 cases of schwannoma and 103 cases of neurofibroma. All the hematoxylin and eosin slides for these cases were reviewed, and tissue microarrays were prepared from the representative areas. Immunohistochemical analysis was performed using antibodies for S-100 protein, calretinin, CD56 and CD34. RESULTS: All the tumors except 3 neurofibromas were positive for the S-100 protein. Calretinin was found in 26.7% of the schwannomas (27/101), but it was not found in any of the neurofibromas. CD56 was positive in 77.2% of the schwannomas (78/101) and in 9.8% of the neurofibromas (10/102). CD34 was positive in 42.5% of the schwannomas (43/101) and in 80.2% of the neurofibromas (81/101). Statistically, calretinin was significantly specific for schwannomas (p<0.001) and CD56 was also sensitive for these tumors (p<0.001). On the other hand, a CD34 expression seemed highly sensitive (p<0.001) for neurofibromas. CONCLUSIONS: We concluded that combined immunohistochemical analysis for calretinin, CD56, and CD34 may be very useful for differentiating schwannomas from neurofibromas.
Antibodies ; Calcium-Binding Protein, Vitamin D-Dependent ; Diagnosis, Differential ; Eosine Yellowish-(YS) ; Hand ; Hematoxylin ; Immunohistochemistry ; Neurilemmoma ; Neurofibroma ; S100 Proteins

STUDY DESIGN: Retrospective study. PURPOSE: We examined the clinical and radiological outcomes of patients who received revision surgery for pseudarthrosis or adjacent segment disease (ASD) following decompression and instrumented posterolateral fusion (PLF). OVERVIEW OF LITERATURE: At present, information regarding the outcomes of revision surgery for complications such as pseudarthrosis and ASD following instrumented PLF is limited. METHODS: This study examined 60 patients who received PLF for degenerative lumbar spinal stenosis and subsequently developed pseudarthrosis or ASD leading to revision surgery. Subjects were divided into a group of 21 patients who received revision surgery for pseudarthrosis (Group P) and a group of 39 patients who received revision surgery for ASD (Group A). Clinical outcomes were evaluated using the visual analogue scales for back pain (VAS-BP) and leg pain (VAS-LP), the Korean Oswestry disability index (K-ODI), and each patient's subjective satisfaction. Radiological outcomes were evaluated from the extent of bone union, and complications in the two groups were compared. RESULTS: VAS-LP at final follow-up was not statistically different between the two groups (p =0.353), although VAS-BP and K-ODI at final follow-up were significantly worse in Group P than in Group A (all p <0.05), and only 52% of the patients in Group P felt that their overall well-being had improved following revision surgery. Fusion rates after the first revision surgery were 71% (15/21) in Group P and 95% (37/39) in Group A (p =0.018). The rate of reoperation was significantly higher in Group P (29%) than in Group A (5%) (p =0.021) due to complications. CONCLUSIONS: Clinical and radiological outcomes were worse in patients who had received revision surgery for pseudarthrosis than in those who had revision surgery for ASD. Elderly patients should be carefully advised of the risks and benefits before planning revision surgery for pseudarthrosis.
Aged ; Back Pain ; Decompression ; Follow-Up Studies ; Humans ; Leg ; Pseudarthrosis* ; Reoperation ; Retrospective Studies ; Risk Assessment ; Spinal Stenosis* ; Weights and Measures

Objective: This study aimed to determine the serum Dickkopf 1 (DKK1) levels in ankylosing spondylitis (AS) patients and decipher the mechanism of tumor necrosis factor (TNF)-mediated DKK1 regulation in human AS enthesis cells. Methods: The sera were obtained from 103 patients with AS and 30 healthy controls (HCs). The enthesis of facet joints were obtained from 4 AS patients and 5 controls. The serum levels of DKK1 were measured using ELISA and compared between AS and HCs. The impact of TNF on DKK1 expression in human primary spinal enthesis cells was evaluated using various molecular biology techniques and bone formation indicators. Results: AS patients showed higher serum DKK1 levels than HCs after adjusting for age (917.4 [615.3∼1,310.0] pg/mL vs. 826.2 [670.3∼927.8] pg/mL, p=0.043). TNF treatment promoted bone formation and DKK1 expression in both control enthesis cells and those of AS. This enhanced bone formation by TNF was pronounced in AS-enthesis than those of controls. Mechanically, TNF induced NF-κB activation upregulates the DKK1 transcript level. While, NF-κB inhibitor led to downregulate DKK1 expression in the enthesis. Besides, DKK1 overexpression promoted bone formation in enthesis. Conclusion TNF induced DKK1 expression in the enthesis through NF-κB activation. TNF-induced DKK1 expression may play a bone formation in the radiologic progression of ankylosing spondylitis.

Objective: This study aimed to determine the serum Dickkopf 1 (DKK1) levels in ankylosing spondylitis (AS) patients and decipher the mechanism of tumor necrosis factor (TNF)-mediated DKK1 regulation in human AS enthesis cells. Methods: The sera were obtained from 103 patients with AS and 30 healthy controls (HCs). The enthesis of facet joints were obtained from 4 AS patients and 5 controls. The serum levels of DKK1 were measured using ELISA and compared between AS and HCs. The impact of TNF on DKK1 expression in human primary spinal enthesis cells was evaluated using various molecular biology techniques and bone formation indicators. Results: AS patients showed higher serum DKK1 levels than HCs after adjusting for age (917.4 [615.3∼1,310.0] pg/mL vs. 826.2 [670.3∼927.8] pg/mL, p=0.043). TNF treatment promoted bone formation and DKK1 expression in both control enthesis cells and those of AS. This enhanced bone formation by TNF was pronounced in AS-enthesis than those of controls. Mechanically, TNF induced NF-κB activation upregulates the DKK1 transcript level. While, NF-κB inhibitor led to downregulate DKK1 expression in the enthesis. Besides, DKK1 overexpression promoted bone formation in enthesis. Conclusion TNF induced DKK1 expression in the enthesis through NF-κB activation. TNF-induced DKK1 expression may play a bone formation in the radiologic progression of ankylosing spondylitis.