The percutaneous pinning is a simple, effective method for the treatment of displaced supracondylar fractures of the humerus in children. But there is some controversy in the number of pins used and the method of pin insertion. The cross pinning method provides more stability at the fracture site but the risk of ulnar nerve damage is higher than in lateral pinning method, The senenty-one displaced extension type supracondylar fractures were treated by closed reduction and percutaneous cross pinning from January 1991 to October 1994. Among them, the medial pin was inserted in elbow extension in twenty-eight cases and in forty- three cases the medial pin was inserted in elbow flexion. Ulnar nerve injury occured postoperatively in six cases, in which the pin was inserted with the elbow in flexion position. These results may suggest that when percutaneous cross pinning method is selected to fix the supracondylar fracture of the humerus, it would be safer to insert one or two lateral pins with the elbow in full flexion position followed by one medial pin in extension position in order to reduce the risk of loss of reduction and ulnar nerve damage.
Child ; Elbow ; Humans ; Humerus ; Methods ; Ulnar Nerve

We present a case of medial malleolus and deltoid ligament loss with extensive overlying soft tissue defect from crushing injury. The resultant gross medial ankle instability necessitated deltoid ligament reconstruction using a bone-patellar tendon graft.
Ankle ; Child ; Humans ; Ligaments ; Patella ; Patellar Ligament ; Tendons ; Transplants

BACKGROUND AND OBJECTIVES: The beneficial effects of statins in preventing cardiovascular events may depend, in part, on their anti-inflammatory action. We previously reported that low dose statin therapy has cholesterol lowering effects, but no effect on inflammation, and proposed that a sufficient dose of therapy might be needed to achieve anti-inflammatory action. The aims of this study were to confirm the suggestions made in our previous study. SUBJECTS AND METHODS: Fifteen unstable angina patients who were enrolled in our previous study were evaluated. The usual dose (20 mg) of simvastatin was administrated for 26 weeks, blood samples collected following the administration and tested for their lipid profiles and inflammatory markers (IL-6, CRP). The changes in the lipid profiles and inflammatory markers, from baseline levels, to the usual and low doses of statin therapy were evaluated. RESULTS: The changes in the IL-6 and hsCRP levels after the usual dose simvastatin therapy compared with the baseline levels were -72.8 and -59.6% (p< 0.05), respectively. The changes in the IL-6 and hsCRP levels after the usual dose simvastatin therapy compared with a 5 mg dose were -77.2 and -47.1% (p< 0.05), respectively. There was statistically significant correlation between the change in the levels of IL-6 and hsCRP during statin therapy. CONCLUSION: Our data confirmed the preliminary result of Chung et al, which suggested the usual dose of simvastatin is required to inhibit the inflammation of unstable plaque in patients with unstable angina associated with hypercholesterolemia.
Angina, Unstable* ; C-Reactive Protein ; Cholesterol ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypercholesterolemia ; Inflammation ; Interleukin-6* ; Simvastatin*

To evaluate the functional and radiologic outcomes of extracorporeal shock wave therapy (ESWT) in shoulders with chronic calcific tendinitis. We report a retrospective study to compare the outcome after ESWT (group l, 15 cases) with the effect of medication treatment (group 2, 15 cases) in patients with chronic calcific tendinitis. Patients were aged 42 to 58 years, mean of 48 years and treated with extracorporeal shock waves or medication from September 2012 to May 2014. The ESWT was performed six cycles of shock waves, weekly treatment for the three cycles and the rest cycles after 2 weeks of pause. In the same period, there were 12 women and 3 men treated with medication treatment for calcific tendinitis. The clinical outcomes were evaluated according to Constant and Murley score and pain visual analogue scale. Radiologic evaluation was performed to confirm disintegration of calcific deposits 3 months and 6 months after treatment. Clinical outcomes were significantly improved in ESWT group, and there was significant difference between ESWT group and medication group. In radiographic evaluation, the calcific deposit was significantly decreased in ESWT group. ESWT therapy is more effective to achieve functional improvement and to alleviate pain in the patients with calcific tendinitis of the shoulder.
Female ; Humans ; Male ; Retrospective Studies ; Shock* ; Shoulder* ; Tendinopathy*

Nitric oxide(NO) is thought to play an important role in development and plasticity of brain. In this study, we aimed to examine the expression of neuronal NOS and NADPH-diaphorase (NADPH-d) activity in the developing rat brain. The results show that there is a great variation in the time of appearance of the earliest NOS containing cells depending on their location: At the 15th embryonic day weakly stained cells were present in caudate-putamen, and neurons in the sensory trigeminal nucleus and the solitary nucleus displayed an intense staining. The NOS neurons in orbital neocortex, bed nucleus of stria terminalis, paraventricular hypothalamic nucleus, lateral hypothalamic area and mammillary body appeared first at the 18th embryonic day. The supraoptic nucleus and superior and inferior colliculi also weakly labeled at the 18th embryonic day, At the loth embryonic day, positive cells appeared in horizontal limb of diagonal band, anterior olfactory nucleus and parafascicular thalamic nucleus. In the cerebellum, weak NOS staining was present in fibers and cells situated below Purkinje cert layer. The Purkinje cell layer displayed a weak, rather diffuse activity throughout the cerebellum at postnatal day 0. At the 4th postnatal day. the reaction product in the Purkinje cell layer became more distinct. At the 10th postnatal day, the inner part of molecular layer became populated by NOS positive basket cells, and the reaction products on the Purkinje cells began to disappear. The present results showed that NOS in the rat brain is expressed in different populations of neurons at different stages of development. This expression pattern of NOS suggests that NO may play a role in the developmental remodelling of the mammalian brain.
Animals ; Brain* ; Cerebellum ; Extremities ; Hypothalamic Area, Lateral ; Inferior Colliculi ; Intralaminar Thalamic Nuclei ; Mamillary Bodies ; Neocortex ; Neurons ; Nitric Oxide Synthase* ; Nitric Oxide* ; Orbit ; Paraventricular Hypothalamic Nucleus ; Plastics ; Purkinje Cells ; Rats* ; Septal Nuclei ; Solitary Nucleus ; Supraoptic Nucleus ; Trigeminal Nuclei

Encephalopathy is a term for any diffuse disease of brain that alters brain function or structure with very different etiologies and prognoses. There are some reports that steroids have good effects on some encephalopathies with nonvasculitic autoimmune causes. We describe a 63-year-old woman with a 3-month history of progressive gait disturbance, cognitive decline and increasing confusion in whom steroid treatment resulted in dramatic clinical recovery.
14-3-3 Proteins ; Brain ; Female ; Gait ; Humans ; Middle Aged ; Prognosis ; Steroids

No abstract available.
Aging* ; Endocrine Cells* ; Neurons*

OBJECTIVE: In this study, We investigated the circulating level of leptin in the maternal and cord serum to estimate the effect of leptin on the fetal growth. METHODS: In full-term pregnancy, right after delivery, we calculated the concentration of leptin in the maternal and cord serum by using an immunoassay. we studied the relation between these value, the maternal BMI at the time of delivery, the neonatal body weight. RESULTS: At the time of delivery, mean concentration of maternal leptin and cord leptin showed 335.7 pg/ml and 118.3 pg/ml and there was no statistical significance between them. Mean concentration of matenal leptin has positive relation with maternal body weight. but not to neonatal weight. Mean concentration of cord serum leptin has a positive relation with neonatal weight. There was a correlation between the maternal BMI and the neonatal weight at the time of delivery. We evaluated the mean leptin level of neonates of two different sexes, that difference did not show a statistically significant level. CONCLUSION: In this study, no correlation was found between concentration of maternal leptin and cord leptin. These data suggested that the cord serum leptin has a positive relation with fetal growth independantly, regardless of maternal leptin and maternal BMI.
Body Weight ; Fetal Blood* ; Fetal Development ; Humans ; Immunoassay ; Infant, Newborn ; Leptin* ; Pregnancy

OBJECTIVE: The purpose of this study was to establish the distribution and obstetric outcomes in women with congenital uterine malformations. METHODS: A review of the medical records from the department of obstetrics and gynecology from January 1995 to June 2004 were diagnosed 79 patients with congenital uterine malformations. All of the cases were divided into groups according to classification of ASRM (American Society for Reproductive Medicine), which is based on the degree of failure of normal development of the female genital tact. The obstetric outcomes were compared between the groups. Statistical processing of the material was carried with Pearson chi square test. RESULTS: 79 patientss with congenital uterine malformations were diagnosed by operation or imaging studies. Symmetric congenital uterine malformations, consisting of bicornuate uterus (45.6%), septate uterus (19.0%), and uterus didelphys (31.6%), were the most common, constituting 96.2% of the malformations. Two patients (2.5%) had unicornuate uterus and one patient (1.3%) had arcuate uterus. No cases of the agenesis type and T-shaped uteri were found. 196 pregnancies occurred in the 74 patients. Only 43.4% of the pregnancies reached term, while 8.2% resulted in preterm delivery, and 48.4% terminated as miscarriages. CONCLUSION: Obstetric complications occur more frequently among women with congenital uterine malformations than among women in general. Knowledge concerning of congenital uterine malformations is important in recognizing and managing the obstetric complications that may result.
Abortion, Spontaneous ; Classification ; Female ; Gynecology ; Humans ; Medical Records ; Obstetrics ; Pregnancy ; Uterus

17alpha- hydroxylase deficiency is a rare form of congenital adrenal hyperplasia and characterized by the coexistance of hypertension caused by the hyperproduction of mineralocorticoid precursors and sexual abnormalities, such as female pseudohermaphroditism and sexually infantile female with 46,XX karyotype or male pseudohermaphroditism with 46, XY karyotype, due to impaired production of sex hormone. We experienced a case of 17alpha- hydroxylase deficiency (46,XX) presented with primary amenorrhea, sexual infantilism, and hypertension. We report this case with a brief review of the concerned literatures.
46, XX Disorders of Sex Development ; 46, XY Disorders of Sex Development ; Adrenal Hyperplasia, Congenital ; Amenorrhea* ; Female ; Humans ; Hypertension* ; Karyotype ; Sexual Infantilism