Recurrent posterior shoulder instability is a debilitating condition that is relatively uncommon, but its diagnosis in young adults is increasing in frequency. Several predisposing factors for this condition have been identified, such as the presence of an abnormal joint surface orientation, an osteochondral fracture of the humeral head or glenoid cavity, and a postero-inferior capsuloligamentary deficit, but their relative importance remains poorly understood. Whilst, conservative treatment is effective in cases of hyperlaxity or in the absence of bone abnormality, failure of conservative treatment means that open or arthroscopic surgery is required. In general, soft-tissue reconstructions are carried out in cases of capsulolabral lesions in which bone anatomy is normal, whereas bone grafts have been required in cases where posterior bony Bankart lesions, glenoid defects, or posterior glenoid dysplasia are present. However, a consensus on the exact management of posterior shoulder instability is yet to be reached, and published studies are few with weak evidence. In our study, we report the reconstruction of the glenoid using iliac bone graft in a patient suffering recurrent posterior shoulder instability with severe glenoid bone defect.
Arthroscopy ; Causality ; Consensus ; Diagnosis ; Glenoid Cavity ; Humans ; Humeral Head ; Ilium ; Joint Instability ; Joints ; Shoulder* ; Transplants* ; Young Adult

No abstract available.
Cyclosporine ; Necrobiosis Lipoidica ; Necrobiotic Disorders

Recurrent posterior shoulder instability is a debilitating condition that is relatively uncommon, but its diagnosis in young adults is increasing in frequency. Several predisposing factors for this condition have been identified, such as the presence of an abnormal joint surface orientation, an osteochondral fracture of the humeral head or glenoid cavity, and a postero-inferior capsuloligamentary deficit, but their relative importance remains poorly understood. Whilst, conservative treatment is effective in cases of hyperlaxity or in the absence of bone abnormality, failure of conservative treatment means that open or arthroscopic surgery is required. In general, soft-tissue reconstructions are carried out in cases of capsulolabral lesions in which bone anatomy is normal, whereas bone grafts have been required in cases where posterior bony Bankart lesions, glenoid defects, or posterior glenoid dysplasia are present. However, a consensus on the exact management of posterior shoulder instability is yet to be reached, and published studies are few with weak evidence. In our study, we report the reconstruction of the glenoid using iliac bone graft in a patient suffering recurrent posterior shoulder instability with severe glenoid bone defect.
Arthroscopy ; Causality ; Consensus ; Diagnosis ; Glenoid Cavity ; Humans ; Humeral Head ; Ilium ; Joint Instability ; Joints ; Shoulder ; Transplants ; Young Adult

Absorptiometry, Photon ; Adult ; Animals ; Bone Density ; Euthanasia ; Humans ; Latency Period (Psychology) ; Mandible ; Mandibular Osteotomy ; Molar ; Osteogenesis, Distraction ; Osteomyelitis ; Osteotomy ; Radiography ; Rats ; Wound Healing

BACKGROUND AND OBJECTIVES: The relationship between actinomycosis and chronic tonsillar diseases, such as chronic recurrent tonsillitis or tonsillar hypertrophy, has been reported several times; but there seems to remain some controversy. The aim of this study was to find out the incidence of actinomycosis in the tonsil and its clinical significance. SUBJECTS AND METHOD: A histologic evaluation with tonsil specimen for actinomycosis was done for 300 patients who had undergone tonsillectomy from July 2005 to February 2006. Other clinical features such as age, sex, chief complaints, tonsil size, frequency of recurrent tonsillitis, and laboratory findings were also analyzed. RESULTS: The incidence of actinomycosis in tonsil was significantly high in adult group. There was no significantly statistical difference in the rate of actinomycosis according to sex, chief complaints, tonsil size, frequency of recurrent tonsillitis, number of leukocytes, and hemoglobin. CONCLUSION: Actinomycosis seems to have no causal role in recurrent tonsillitis or tonsillar hypertrophy. However, the possibility of actinomycosis should be considered in unusual tonsillar hypertrophy patients.
Actinomycosis* ; Adult ; Humans ; Hypertrophy ; Incidence* ; Leukocytes ; Palatine Tonsil* ; Tonsillectomy ; Tonsillitis

We have investigated the changes of DNA ploidy and S-phase fraction in proliferative lesions of rat liver. Proliferative lesions were induced by diethylnitrosamine and partial hepatectomy. DNA ploidy was measured by flow cytometer, and S-phase fraction was measured by in situ bromodeoxyuridine(BRdU)-anti BRdU monoclonal antibody techniques. Normal liver and initiated lesion revealed DNA diploidy or DNA tetraploidy. Hepatocyte nodule (NODULE) and hepatocelular carcinoma (HCC) revealed DNA diploidy, tetraploidy or aneuploidy. S-phase fraction was 1.0+/-0.9, 1.0+/-0.9m 3.7+/-2.3, 5.5+/-4.9, and 13.8+/-11.6 in normal liver, initiated lesion, NODULE not associated with HCC, NODULE associated with HCC, and HCC, respectively. In NODULE associated with HCC, it was widely distributed, ranging from 0.8 to 15.5%. In conclusion, S-phase fraction appeared to be increased as the hepatocarcinogenesis proceeded, but DNA ploidy did not. There was a heterogeneity of DNA ploidy and S-phase fraction in the proliferative hepatic lesions.
Rats ; Animals ; Carcinoma, Hepatocellular

No abstract available.
Interferon-gamma Release Tests* ; Lupus Vulgaris*

The frequency of stab wounds is gradually increasing and patients with stab wounds visit the hospital through the emergency room. Management options for patients with stab wound include mandatory exploration and selective observation, but recently many authors have emphasized the importance of selective conservation with development of diagnostic procedure and controversy still exists concerning the management of patients with stab wounds. We retrospectively analysed the clinical data of 78 patients with stab wounds who visited the emergency room of St. Paul's Hospital over 5 years from January 1 1992 to December 31 1996. The following results were obtained. 1) The most prevalent age group were the twenties & the thirties(58.9% of patient) and then most patients were of young age. The male to female ratio was 2.9: 1. 2) Most injuries occurred at night between 8p.m. and 4a.m.(61.5%) and during September injuries were most frequent. 3) The most common causes of stab wound were fighting(55.1%) followed by suicide (21.8%), then accidents including traffic accidents(16.7%) and robbery(6.4%). 4) The instruments most commonly used were knives(53.8%) and broken glass(28.2%). 5) Half of patients were drunk from alcohol and in 3 cases from an antipsychotic drug. 6) In 11 cases(14.1%), there were multiple wound sites and in 8 cases(10.3%) superficial wounds into subcutaneous fatty tissue. 7) According to stab wound sites, the extremities were wounded in 36 cases(46.2%), chest in 21 cases(26.9%), abdomen in 15 cases(19.2%) and neck in 7 cases(9.0%). 8) Emergency explorations were performed in 43 cases(55.1%) under general or regional anesthesia, which included neck in 4 cases(9.3%), chest in 3 cases(7.0%), abdomen in 11 cases(25.6%) and extremity in 25 cases(58.1%). In exploratory laparotomy, negative exploration rate was 18.2%. 9) Death occurred in 2 cases(2.6%). One died due to sepsis with multiple colon perforation and the other due to hypovolemic shock with Superior Vena Cava injury.
Abdomen ; Adipose Tissue ; Anesthesia, Conduction ; Colon ; Emergencies ; Emergency Service, Hospital ; Extremities ; Female ; Humans ; Laparotomy ; Male ; Multiple Trauma ; Neck ; Retrospective Studies ; Sepsis ; Shock ; Suicide ; Thorax ; Vena Cava, Superior ; Wounds and Injuries ; Wounds, Stab*

PURPOSE: Although cystoscopy is useful for diagnosing urologic diseases, it is a painful procedure. Pain during cystoscopy can be reduced with the help of a midazolam induced anesthetic technique. However, the safety of anesthetic cystoscopy has not been established. This study investigated the value and safety of midazolam induced anesthetic cystoscopy. MATERIALS AND MTHODS: 50 male patients, who were examined with cystoscopy, were divided into two groups. Group I patients (n=25) received ketorolac 30mg. Group II patients (n=25) were treated with midazolam 3mg, which was increased to 5mg if necessary. All the group II patients were treated with flumazenil 0.2mg after anesthetic cystoscopy. There was no significant difference in age and weight. The mean midazolam dose was 3.72mg in group II. The blood pressure, pulse rate and respiratory rate were checked and the vital signs were monitored continuously by an oxymeter and electrocardiography. The sedation score, pain scale, recovery from sedation, and satisfaction were evaluated. RESULTS: The pain scale in group II was significantly lower than that of group I. Although the blood pressure, pulse rate or respiratory rate changed slightly during cystoscopy, they were within the normal limit and there was no need for additional treatment. Recovery from anesthetic cystoscopy was good and satisfaction for the anesthetic cystoscopy was high. CONCLUSIONS: The pain scale of the midazolam group was lower than that of control group and the patients' satisfaction is better than when using of conventional cystoscopy. Midazolam induced anesthetic cystoscopy is a useful and safe procedure.
Anesthesia* ; Blood Pressure ; Cystoscopy* ; Electrocardiography ; Flumazenil ; Heart Rate ; Humans ; Ketorolac ; Male ; Midazolam* ; Respiratory Rate ; Urologic Diseases ; Vital Signs

PURPOSE: Although cystoscopy is useful for diagnosing urologic diseases, it is a painful procedure. Pain during cystoscopy can be reduced with the help of a midazolam induced anesthetic technique. However, the safety of anesthetic cystoscopy has not been established. This study investigated the value and safety of midazolam induced anesthetic cystoscopy. MATERIALS AND MTHODS: 50 male patients, who were examined with cystoscopy, were divided into two groups. Group I patients (n=25) received ketorolac 30mg. Group II patients (n=25) were treated with midazolam 3mg, which was increased to 5mg if necessary. All the group II patients were treated with flumazenil 0.2mg after anesthetic cystoscopy. There was no significant difference in age and weight. The mean midazolam dose was 3.72mg in group II. The blood pressure, pulse rate and respiratory rate were checked and the vital signs were monitored continuously by an oxymeter and electrocardiography. The sedation score, pain scale, recovery from sedation, and satisfaction were evaluated. RESULTS: The pain scale in group II was significantly lower than that of group I. Although the blood pressure, pulse rate or respiratory rate changed slightly during cystoscopy, they were within the normal limit and there was no need for additional treatment. Recovery from anesthetic cystoscopy was good and satisfaction for the anesthetic cystoscopy was high. CONCLUSIONS: The pain scale of the midazolam group was lower than that of control group and the patients' satisfaction is better than when using of conventional cystoscopy. Midazolam induced anesthetic cystoscopy is a useful and safe procedure.
Anesthesia* ; Blood Pressure ; Cystoscopy* ; Electrocardiography ; Flumazenil ; Heart Rate ; Humans ; Ketorolac ; Male ; Midazolam* ; Respiratory Rate ; Urologic Diseases ; Vital Signs