No abstract available.
Aged* ; Femur Neck* ; Hemiarthroplasty* ; Humans

Seventeen patients with classical rheumatoid arthritis have been treated with gold sodium thiomalate(G.S.T) injection and followed up for 1.7 years on average. The results obtained are as follows: 1. Clinical improvement was obtained in 12(70.3%) out of 17 cases, but only in 5 cases(29.3%) marked and persisting improvement was obtained. Such improvement was first noticed when the total dose of the gold sodium thiomalate reached 500mg or more, and also noticed about 10 weeks after initiation of G.S.T therapy. 2. Changes in laboratory parameters such as hemoglobin, hematocrit, eosinophilia, titers of rheumatoid factor and C-reactive protein, and proteinuria began to appear at the time of the clinical improvement. 3. Adverse reaction consisted mostly of mucocutaneous lesions. The main causes of drop-out during therapy also are severe skin rashes and pruritus. Most of the adverse reactions appeared when the total dose of G.S.T. administered reached over 500mg. In two severe cases skin rashes terminated the gold therapy. Our findings suggest, because of high incidence of adverse reaction during G.S.T therapy, repeated careful clinical and laboratory examination of the patient are mandatory especially when the total dose of G.S.T is reached 500mg. In spite of the well documented reports of the maintenance gold therapy for rheumatoid arthritis it is felt that the maintenance gold therapy should be studied further before it can be safely used as a routine in daily rheumatology practice because of its toxicity.
Arthritis ; Arthritis, Rheumatoid ; C-Reactive Protein ; Eosinophilia ; Exanthema ; Gold Sodium Thiomalate ; Hematocrit ; Humans ; Incidence ; Proteinuria ; Pruritus ; Rheumatoid Factor ; Rheumatology ; Sodium

Repeated throwing of baseballs by juvenile pitchers is known to cause damages to bone and cartilage as well as soft tissue in the involved upper extremity. Authors present 4 cases of osteochondral lesion at capitellum of the humerus as a result of repeated insult by throwing baseballs in the juvenile pitchers. Pain and limitation of extension of the affected elbow were the commonest symptoms. Cystic change or osteochondral loose body was found on plain X-ray. Treatment consisted of rest and analgesic administration in the patient who has no loose body, while in case of having loose body it was removed surgically without further treatment to the crater. In spite of the rapid relief of the pain by these treatment, limitation of extension persisted for considerable period of time. It is strongly suggested not to overlook elbow pain in young adolescent whose bone is still growing and who can hardly withstand repeated insult to prevent the development of baseball elbow.
Adolescent ; Baseball ; Cartilage ; Elbow ; Humans ; Humerus ; Osteochondritis ; Upper Extremity

Diaphyseal fractures of the long bone associated with massive soft tissue injury or severe comminution is difficult to treat. Fracture healing is often delayed due to the damaged soft tissue, deep seated wound infection, fracture instability and poor local circulation. The delayed fracture healing necessitates prolonged immobilization of the limb which results in joint stiffness. Various type of fracture treatment was suggested for this type of fractures to ease the treatment. The Wagner's apparatus was one of the device to treat it, which was originally introduced as a device for controlled leg lengthening. Its use also has been expanded to serve as a rigid unilateral external fixation frame for fracture. In order to obtain satisfactory fracture union without adjacent joint contracture, the Wagner's apparatus has been employed by us in three cases who were hospitalized in Kangnam St. May's Hospital. The experience of this technique was very encouraging; therefore we recommend its wide application in fracture treatment in cases of the patient who can not receive the bilateral external fixation frame.
Contracture ; Extremities ; Fracture Healing ; Humans ; Immobilization ; Joints ; Leg ; Lower Extremity ; Soft Tissue Injuries ; Wound Infection

The 56-kilodalton protein genes of Orientia tsutsugamushi TA678, TA686, TA716, TA763 strains were amplified by PCR. The amplified products were sequenced and cloned into pIH821 vector. The recombinant proteins were expressed in Escherichia coli as fusion proteins with maltose binding protein. The recombinant proteins were purified and used for the sensitization of sheep RBCs and the reactivity of the recombinant 56-kDa proteins of Orientia tsutsugamushi TA 678, TA686, TA716 strains were analyzed with 40 sera from scrub typhus patients in Korea, 40 sera from scrub typhus in Thailand, Malaysia and Philippines. The 56-kDa protein coding DNA sequence of Orientia tsutsugamushi TA678, TA686, TA716 show 70 to 88% homology with other known strains and four variable regions are also observed. 39 of 40 sera from scrub typhus patients in Korea showed the strongest reactivity to the recombinant protein of Boryong strain and one sera showed the strongest reactivity to the recombinant protein of Gilliam strain. 14 of 40 sera from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of TA686 strain and 12 sera showed the strongest reactivity to the recombinant protein of TA716 strain. No serum from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of Boryong strain.
Asian Continental Ancestry Group* ; Base Sequence ; Chungcheongnam-do ; Clinical Coding ; Clone Cells ; Cloning, Molecular* ; Escherichia coli ; Hemagglutination Tests* ; Hemagglutination* ; Humans ; Korea ; Malaysia ; Maltose-Binding Proteins ; Orientia tsutsugamushi* ; Philippines ; Polymerase Chain Reaction ; Recombinant Proteins ; Scrub Typhus ; Sheep ; Thailand

Hemorrhagic fever with renal syndrom is an acute febrile disease which is caused by Hantanvirus and several other viruses that belong to the genus Hantavirus. Gl and G2 glycoproteins of Hantanvirus have been thought to be involved in protective immunity against Hantanvirus infection. In this study, the antigenicity of G1 and G2 glycoproteins in cell mediated immune response was investigated. When peripheral blood mononuclear cell fraction from recovered hemorrhagic fever with renal syndrome patient was cultivated with a recombinant protein containing amino-terminal 78 amino acids of G2 glycoprotein, these cells were activated to proliferate and secreted significant amount of interleukin-2 and interferon-r. These results suggest that T cell epitope exists in the amino-terminal region of G2 glycoprotein.
Amino Acids ; Epitopes, T-Lymphocyte ; Fever ; Glycoproteins* ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Interleukin-2

Incorporation of bromodeoxyuridine(BrdU) and expression of osteocalcin and transglutaminase C(TGase C) during fracture healing and distraction osteogenesis were investigated in the rat with immunohistochemical studies. Transverse osteotomy was made at the proximal tibia. Bilateral dynamic mini-fixator was applied to immobilize the fracture and also to lengthen the leg. Distraction was started, at the rate of 0.25 mm twice daily, from the 4th operative day and continued for 7 days. Animals were killed for immunohistochemical studies on the 1st, 3rd, 5th, 7th, 14th, 28th, 42nd, 56th, and 84th day after osteotomy or distraction. Longitudinal histologic sections of the healing bone were stained with monoclonal antibodies against BrdU, osteocalcin, and TGase C. Radiologically, complete fracture healing was achieved in 6 weeks after osteotomy, while neo-osteogenesis was successfully achieved in the distracted gap in 7 weeks after the completion of distraction, During active healing stage of the fracture and distraction osteogenesis, BrdU was mainly expressed in the perisoteal and endosteal osteoprogenitor cells while osteocalcin was expressed in the proliferating osteoprogenitor cells, osteoblast, osteocyte, osteoid matrix, and chondrocyte. The expression of BrdU and osteocalcin in the mesenchymal cells from the surrounding soft tissues around the osteotomy site was negligible. At the site of enchondral bone formation, TGase C was expressed in the cytomplasm of more centrally located and matured chondrocytes, while oseocalcin was mainly expressed in the cytoplasm of peripherally located chondrocyte. These findings may suggest that osteocalcin participates in early phase of enchondral bone formation, while TGase C in the late phase, suggesting the role of TGase C in matrix stabilization. At the site of intramern-branous bone formation, the expression of TGase C was weakly positive in both osteoprogenitor cell and osteoblast. The reason of the difference in the expression of TGase C between the enchondral bone formation and intrarnembranous bone formation should be further investigated. Fracture healing and distraction osteogenesis was predominantly induced by intramembranous ossification rather than enchondral ossification. Periosteal osteoprogenitor cells appeared to initiate and to lead bone formation after osteotomy and distraction. Active proliferation and differentiation of osteoprogenitor cell ocurred during entire periods of distraction. Also, active osteoid matrix formation and mineralization was started from the 5th day of distraction and continued thereafter for further 4 weeks after completion of the lengthening. These findings indicate that preservation of the periosteum is essential to achieve successful fracture healing and distraction osteogenesis.
Animals ; Antibodies, Monoclonal ; Bromodeoxyuridine ; Chondrocytes ; Cytoplasm ; Fracture Healing ; Leg ; Miners ; Osteoblasts ; Osteocalcin ; Osteocytes ; Osteogenesis ; Osteogenesis, Distraction ; Osteotomy ; Periosteum ; Rats ; Tibia

BACKGROUND/AIMS: Phase IIb clinical study of Stillen(TM), a novel cytoprotectant, for gastritis showed 180 mg of Stillen, t.i.d. for 2 weeks results in a significant increase of cure rate when compared with a placebo group. It is reported that antioxidative effect and strengthening the endogenous cytoprotective molecules of the gastric mucosa play a pivotal role for cytoprotective action of Stillen(TM). The aim of this phase III multicenter, double-blind comparative study was to assess the efficacy of Stillen(TM) for the treatment of erosive gastritis. METHODS: Five hundred and twelve patients with erosive gastritis were enrolled and divided into three groups. Each group received 180 mg or 360 mg of Stillen(TM) or 600 mg of cetraxate (Neuer(TM)) t.i.d. for 2 weeks, respectively and a follow-up endoscopic examination for evaluation. RESULTS: Patients treated with 180 mg and 360 mg of Stillen(TM) had a significantly improved endoscopic cure rate of gastritis (55.6% and 57.5%, respectively) compared with patients treated with 600 mg of cetraxate (35.5%, p<0.001). Endoscopic improvement rate was also significantly higher in 180 mg group (67.3%) and 360 mg group (65.0%) of Stillen(TM) treated patients than cetraxate treated group (46.4%, p<0.001). During the study, both Stillen(TM) and cetraxate were well tolerated. CONCLUSIONS: These results clearly demonstrate that Stillen(TM) is an efficacious, safe, and well-tolerated treatment for gastritis.
Follow-Up Studies ; Gastric Mucosa ; Gastritis* ; Humans

No abstract available.
Hypothyroidism* ; Immunoglobulins*

Postcholecystectomy syndrome is the persistence or recurrence of symytom complex following cholecystectomy, The majority of the patients have mild symptoms. However, the cause of recurrent symptoms is often obscure and as a consequence, a plan of management is difficult to formulate. Recently ERCP has proved to be increasingly helpful in the investigation of postcholecystectomy patients. The purpose of this study was to test the effectiveness of the ERCP in the evaluation of patients with postcbiolecystectomy syndrorae. The results are as follows 1) 102 postcholecystectomy patients were studied by endoscopic retrograde cholangiopancreatography and successful cannulation with demonstration of at least one duct was achieved in 49 of 50 jaundiced patients and in 49 of 52 non-jaundiced patients. The overall success rate was 96. 1%. 2) The results of ERCP were normal in 26 patients(26.5%) and abnormal in 72 patients (73.5%), Only 3 of 50 jaundiced patients were normal, but 23 of 52 non-jaundiced patients showed no abnormal findings. 3) The most common abnormality was biliary stone in common bile duct and intrahepatic duct which were present in 51 patients(50%). Cholangitis without stone was next common finding which was in 13 patients(13%). Of the remaining patients have air biligram, 2 CBD stricture, 1 CBD aseariasis & 1 chronic pancreatitis. 4) Time lapse between onset of symptoms and cholecystectomy was variable. 31 patients were studied less than 2 years after cholecystectomy. 18 of these patients had jaundice and 13 had no jaundice. Within 2 years afte chklecystectomy, the biliary stone was most common finding which were present in 14 out of 31 patients.
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Cholecystectomy ; Common Bile Duct ; Constriction, Pathologic ; Humans ; Jaundice ; Pancreatitis, Chronic ; Postcholecystectomy Syndrome ; Recurrence