No abstract available.
Hypertrophy*

No abstract available.
Kinetics* ; Wrist*

No abstract available.
Antibodies* ; Humans ; Leprosy*

We applied arthroscopy in the diagnosis of thirty four patients with internal derangement of the knee from March to August, 1982. Its results were compared with clinical diagnosis and arthrographic findings. We also performed arthrofomy in twenty nine patients and the final diagnosis enabled us to evaluate the diagnostic accuracy of each method. The accuracy of clinical diagnosis was 63.4%. Arthrographic findings were correct in 77.8%. The diagnostic accuracy of arthroscopy was 92.3% with one false negative case. Unnecessary operations were avoided in five patients with the assistance of negative findings of arthroscopy. Arthrography and arthroscopy were complementary in the diagnosis of internal derangement of the knee.
Arthrography ; Arthroscopy ; Diagnosis ; Humans ; Knee ; Methods

After subarachnoid hemorrhage, transient hypoglycorrhachia is not unusual but prolonged hypoglycorrhachia has been reported rarely. We report a 67-year-old woman who show prolonged hypoglycorrhachia for more than one month after subarahnoid hemorrhage without evidences of infection and malignancy.
Aged ; Female ; Hemorrhage ; Humans ; Subarachnoid Hemorrhage*

Blink reflex (BR) was known as a useful test fordetection of brainstem lesions and cranial neuropathy. We performed BR test in 52 non-insulin dependent diabetics, and the results were compared with 26 controls. In diabetics, 23 patients (44.2%) had abnormal results with delayed R1 in 20 (38.5%), delayed ipsilateral R2 in 6 (11.5%) and delayed contralateral R2 in 4 (7.7%). BR abnormalities were related to age and presence of peripheral neuropathy, but not related to duration of diabetes and fasting blood sugar level. It is suggested that BR test could be an additional electrodiagnostic tool for the diabetic neuropathy, especially to evaluate a subclinical brainstem or cranial nerve involvement.
Blinking* ; Blood Glucose ; Brain Stem ; Cranial Nerve Diseases ; Cranial Nerves ; Diabetic Neuropathies ; Fasting ; Humans ; Peripheral Nervous System Diseases

Hypokalemia causes metabolic alkalosis and morphological changes of the kidney. K⁺ balance is regulated not only by ion channels or pump gene, but also by various genes including NF-E2-related factor 2 (Nrf2). Previous study suggested the possibility that Akt and ERK kinase may be involved in Nrf2 transcriptional gene activation. In present study, we investigate the alterations of Akt, p-Akt, ERK, p-ERK protein in both normal kidney and K⁺-deficient diet kidney using Western blot analysis, and immunohistochemisrty. Our western blot data showed that the expression of Akt and p-Akt was increased gradually in K⁺-depleted diet (from 1W-3W) compared to normal group. The expression of ERK and p-ERK was markedly increased in K⁺-depleted diet 2W in comparison with normal group. Based on our immunostaining results, Akt protein immunoreactivity was prominently increased in outer medullary collecting duct, especially in K⁺-depleted diet 2 weeks. The localization of p-Akt proteins in K⁺-depleted groups was not different from normal group, but the immunoreactivity was significantly increased in distal convoluted tubule, macula densa and outer medullary thick ascending limb in K⁺-depleted diet 1 and 2 weeks groups. ERK protein immunoreactivity was prominently increased in outer medullary collecting duct, especially in K⁺-depleted diet 2 and 3 weeks. The localization of p-ERK proteins in K⁺-depleted groups was not different from normal group, but the immunoreactivity was prominently increased in the nucleus of outer medullary collecting duct especially in K⁺-depleted diet 2 weeks. Taken together, we suggest that the expression of p-Akt was gradually increased in K⁺-depleted groups of kidney, but the expression of p-ERK was markedly increased in K⁺-depleted diet 2 week group. Hence, the promotion of AKT and ERK phosphorylation in hypokalemic condition may be involved in the regulation of ion channels, ion transporters and subsequent intracellular signal transduction.
Alkalosis ; Animals ; Blotting, Western ; Diet ; Extremities ; Hypokalemia ; Ion Channels ; Ion Transport ; Kidney* ; NF-E2-Related Factor 2 ; Phosphorylation ; Phosphotransferases ; Rats* ; Signal Transduction ; Transcriptional Activation

The wrist joint is composed of midcarpal, radiocarpal and distal radioulnar joints. It is difficult to analyze the motion of these joints by the simple roentgenogram. We reconstructed three dimensional images of the wrist and distal radius from computerized tomogram using a new interactive graphics software written in Pascal and Turbo Graphic. There were 10 normal wrists in neutral position, and two normal and one abnormal wrists in ulnar-radial deviation and one normal wrist in flexion-extension were analyzed in this study. For simplification, the images were reformatted for the scaphoid, the proximal carpal row, the distal carpal row and the distal radius. We established the three dimensional references for wrist by defining the Z axis as the long axis of radius, the X axis as a line which is in horizontal plane and parallel to the anterior cortex of distal radius about 2 cm proximal to the articular surface and the Y axis as the automatically defined line perpendicular to both X and Z axes. We measured the angles between the X-axis and the reference lines of scaphoid and each carpal rows. The scaphoid was internally rotated by 60,0 degrees from X axis, the proximal carpal row by 7.0 degrees and the distal carpal row by 25.6 degrees each. There was only minimal change in the angles during the ulnar and radial deviation. The pattern of angles in abnormal wrist was different from those in normal wrists. In flexion-extension, the angle of distal carpal row was changed significantly, which means there was some error in selecting the reference line of distal carpal row as an axis of motion, or in measuring the angles, or it can be suggested that there is some rotational motion of distal carpal row on the Z axis. The proximal poles of the scaphoid and the triquetrum were displaced ventrally during flexion and dorsally during extension.
Imaging, Three-Dimensional ; Joints ; Radius ; Wrist Joint ; Wrist

Adult onset Still's disease (AOSD) is a systemic autoinflammatory disorder that presents with recurrent fever, extreme fatigue, and joint pain. Pulmonary involvement is not uncommon and, although rare, severe pneumonitis can progress to respiratory failure. Still's disease-associated pneumonitis is generally treated with immunosuppressive agents, but improvement in our understanding of systemic inflammatory processes led us to explore alternative agents. Anakinra is an interleukin-1 receptor antagonist used to treat autoinflammatory disorders resistant to immunosuppressive therapy. Several case reports have demonstrated efficacy of anakinra in treating AOSD, but its relevance in cases complicated with severe pneumonitis has not been examined. Our patient's disease activity was not controlled with systemic steroids and cyclophosphamide. Treatment with anakinra led to a dramatic clinical response. This is the first reported case of AOSD with severe pneumonitis refractory to conventional therapy successfully treated with anakinra.
Arthralgia ; Cyclophosphamide ; Fatigue ; Fever ; Immunosuppressive Agents ; Interleukin 1 Receptor Antagonist Protein* ; Interleukin-1 ; Pneumonia* ; Respiratory Insufficiency ; Steroids ; Still's Disease, Adult-Onset*

PURPOSE: Peritoneal recurrence has been reported to be the most common form of recurrence of gastric cancer. Peritoneal recurrence can generally be suggested by several types of image studies and also if there is evidence of ascites or Bloomer's rectal shelf. It can be confirmed by explorative laparotomy, but diagnostic laparoscopy is a good alternative method and laparoscopic surgery has also been widely used. We reviewed and analyzed the ability of diagnostic laparoscopy to detect peritoneal recurrence or carcinomatosis, and especially for gastric cancer. MATERIALS AND METHODS: We performed a retrospective review the 45 gastric cancer patients who were operated via diagnostic laparoscopy between 2004. 2. and 2009. 3. We analyzed the perioperative clinical characteristics and the accuracy of the diagnostic methods. RESULTS: The study groups included 14 patients who had confirmed gastric cancer, but they suspected to have carcinomatosis, and 31 patients who had previously underwent gastric resection, but they suspected to have recurrence. The mean operation time was 44.1+/-6.9 minutes and the mean postoperative hospital stay was 2.7+/-.8 days. There was one case of operation-related complication and no postoperative mortality occurred. The sensitivities for detecting peritoneal recurrence or carcinomatosis were 92.1% for diagnostic laparoscopy, 29.7% for detecting ascites and rectal shelf on the physical examination, 86.5% for abdominal computed tomography, 69.2% for PET CT and 18.8% for CEA. CONCLUSION: Diagnostic laparoscopy does not require a long operation time or a long hospital stay, and it showed a low complication rate in our study. It has high sensitivity for detecting peritoneal recurrence of gastric cancer. It can be an alternative diagnostic confirmative method and it is useful for deciding on further treatment.
Ascites ; Carcinoma ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Physical Examination ; Recurrence ; Retrospective Studies ; Stomach Neoplasms