No abstract available.
Nortriptyline* ; Plasma*

Segmental fracture of the femoral shaft is known as an unusual injury, usually caused by severe force and associated with marked damage to the soft tissue, and is difficult to treat due to these causes it is a controversal topic in regard to the treatment. Authors analysed 14 cases of segmental fracture of the femoral shaft, except cases associated with hip fracture, which had received operative treatment at Dept. of Orthopaedic Surgery, College of Medicine, Chosun University, from Jan. 1985 to Dec. 1990. The results are summarized as follows; 1. Of 14 cases, there were 12 cases of male and 2 cases of female: male was predominant. Most cases were at their 3rd and 6th decades of age. 2. Traffic accidents were the main causes of injury(11 out of 14 cases.) 3. There were 13 closed fracture and 1 open fracture. 4. In most cases, they accompanied injuries to other vital organ. Among 14 cases, 5 cases accompanied head injury. 5. We treated these fracture by flexible intramedullary nailing in 7 cases, open reduction and internal fixation with plate in 5 cases, locked intramedullary nailing in 2 cases. Bony union was more rapid in the distal fracture than in the proximal fracture. 6. Among 14 cases, primary bone grafting was done in 2 cases. In the group where primary bone grafting had not been done, dealyed union appeared but nonunion was not seen. 7. We could obtain rapid bony union and decreased operation time in the cases which were treated with intramedullary fixation, and thought that intramedullary fixation was a relatively good method in type of this fracture.
Accidents, Traffic ; Bone Transplantation ; Craniocerebral Trauma ; Female ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Hip ; Humans ; Male ; Methods

No abstract available.
Adult* ; Humans

Kirschner-wires and pins are used for the intenal fixation of the acromioclavicular joint. Many surgeons are aware of the tendency of these appliances to migrate, however, few reports of this complication have appeared in literature. This report concerns two instances of migration K-wires from the acromioclavicular joint into the neck, The potential for K-wires to migrate must be recogniged, and more frequent postoperative radiographic studies performed after the insertion of such pins to permit earlier detection of bony resorption and migration. Thereby permitting earlier removal. In cases of young adult, the wires must be removed as soon as the desired theurapeutic results have been obtained.
Acromioclavicular Joint ; Humans ; Neck ; Surgeons ; Young Adult

PURPOSE: To evaluate the objective difference of the shoulder position during ultrasound examination regarding diagnostic value for shoulder lesion, view range and visibility. MATERIALS AND METHODS: A prospective study was performed enrolling 312 patients who underwent diagnostic ultrasonography due to shoulder pain between January 2016 and June 2016. Examination was performed by a single orthopaedic surgeon with 5 years of musculoskeletal ultrasonography experience. Images of the longitudinal and transverse plane of the supraspinatus tendon and the nearby soft tissues (subscapularis and biceps long head tendon, subdeltoid bursa, etc.) were obtained in the three different positions, shoulder extension, modified Crass, and Crass position. The correlation between the demographic data (age, sex and body mass index) and the visual analogue scale (VAS) of the affected shoulder & the capable shoulder position was analyzed. Another orthopaedic independently measured the size of the tear and using classified the image visibility of the supraspinatus, subscapularis, and biceps long head tendon on the short-axis view from the rotator interval into I to III and X. RESULTS: Of the 312 patients, 126 were excluded and total of 186 cases were included in this study. None of the demographic data were related to the possible arm position. However, VAS for pain was the only factor related with the number of possible arm positions during sonography. Kappa agreements for the diagnosis were mostly high of over 0.90. Grades of the short-axis view from the rotator interval in each position were mostly grade II or grade III, which refers to that the anterior portion of supraspinatus tendon, which is the most fragile portion to the tear and it was well-defined regardless of the arm position. The average longitudinal tear sizes were 1.48, 1.52, and 1.61 cm in the shoulder extension, modified Crass (Middleton), and Crass position, respectively. CONCLUSION: Shoulder extension position during ultrasonography examination of shoulder shows similar diagnosis rate of supraspinatus tendon tear or calcific tendinitis compared to modified Crass (Middleton) or Crass position, the two well-known standard positions. It is also a useful position for patients who suffer with severe shoulder pain.
Arm* ; Diagnosis ; Head ; Humans ; Prospective Studies ; Rotator Cuff* ; Shoulder ; Shoulder Pain ; Tears ; Tendinopathy ; Tendons ; Ultrasonography

BACKGROUND: Multi-organ failure from sepsis is very lethal disease entity, which is suspected to be caused by activated inflammatory cells. Inflammatory cells activated by endotoxins generate oxidants and cytokines such as TNF-alpha and IL-6, which in turn stimulate macrophages and neutrophils. Augmented inflammation makes an organ-injury deteriorate into an organ-failure, which may progress to multi-organ failure. This study is designed to evaluate the therapeutic effects of vitamin-C, a scavenger of oxidants, in sepsis. METHODS: Male Sprague-Dawley rats were divided into 3 groups : a control group, a group injected intrapetoneally with LPS(lipopolysaccharide), and a group injected intraperitoneally with LPS and vitamin-C. Each eight rats were sacrified 24 hours and 48 hours after injection, and samples of the blood, the liver and the lung were obtained. Biochemical assays of TNF-alpha level in the blood and malondialdehyde(MDA) level, catalase activity and nitric oxide synthase(NOS) activity in the liver and the lung tissues were performed. RESULTS: Serum TNF-alpha level, tissue lipid peroxidation and tissue i-NOS activity were dramatically increased, and tissue catalase activity was exhausted rapidly in sepsis. High dose vitamin-C administration decreased serum TNF-alpha level, tissue lipid peroxidation and tissue i-NOS induction, and protected against catalase exhaustion. CONCLUSION: high dose vitamin-C therapy was proved to have definite antioxidant effect in septic condition.
Animals ; Antioxidants ; Catalase ; Cytokines ; Endotoxins ; Humans ; Inflammation ; Interleukin-6 ; Lipid Peroxidation ; Liver ; Lung ; Macrophages ; Male ; Models, Animal* ; Neutrophils ; Nitric Oxide ; Oxidants ; Rats* ; Rats, Sprague-Dawley ; Sepsis* ; Tumor Necrosis Factor-alpha

No abstract available.
Nortriptyline* ; Pharmacokinetics*

OBJECTIVES: Manganese is cytotoxic to the central nervous system including basal ganglia. Its toxic mechanism is related to oxidative stress, mediated by toxic free radicals but is specultives. In the present study, we have investigated to manifest apoptosis in manganese-induced cytotoxicity in primary neuronal cell culture of rat basal ganglia. METHOD: To detect apoptotic neuronal cells were stained by the terminal deoxynu-cleotide(TdT)-mediated dUTP nick end-labelling(TUNEL) method and apoptotic changes in nuclei of neurons were observed by electron microscopy. RESULTS: We showed that TUNEL immunostain showed brownish signal in the nuclei of apoptotic cells and the proportions of apoptotic cells in Manganese treatment groups were more higher than controls. On transmission electron microscopy, there were chromatine condensation with margination toward nuclear membrane and condensation of cytoplasm in the treated with luM MnC1, for 48 hours in a basal ganglia neurons. Apoptotic bodies were found and consisted of semilunar-like condensed nuclei with relatively intact cytoplasmic organelles. CONCLUSIONS: Apoptosis appears to be one mechanism in the manganese-induced neuronal cell death. Manganese intoxication is a convenient model for apoptosis study.
Animals ; Apoptosis* ; Basal Ganglia* ; Cell Culture Techniques* ; Cell Death ; Central Nervous System ; Chromatin ; Cytoplasm ; Free Radicals ; In Situ Nick-End Labeling ; Manganese* ; Microscopy, Electron ; Microscopy, Electron, Transmission ; Neurons* ; Nuclear Envelope ; Organelles ; Oxidative Stress ; Rats

Mitomycin C(MMC), an antineoplastic drug, is a potent inhibitor of cell mitosis, and the intravitreal application of MMC can be a useful treatment for proliferative vitreoretinopathy by inhibiting intraocular cellular proliferation. We investigated the retinal toxicity of an intravitreal injection of MMC in the pigmented rabbits electroretinographically and histologically. Pigmented rabbits received various dosages of intravitreal MMC(1.0, 2.0, 3.0, 4.0, 10.0 microgram) at a constant volume of 0.1ml. Eltroretinographic data were obtained on 1, 3, 5, 7, days after injection and compared with preinjection ERG data. On 14 days after injection, we evaluated the retinel toxicity of MMC histologically. A dosage of 1.0 microgram MMC resulted in no demonstrable retinal toxicity by electroretinographical and histological studies. A toxic dose of MMC(2.0, 3.0, 4.0, 10.0 microgram) suppressed the b-wave and that of oscillatory potentials were not affected. This fact may suggest that a toxic dose of intravitreal MMC have caused destructive retinopathy. On the light microscopic examination, the outer layer of the retina was most sensitive to the toxic effect of MMC, and higher than 2.0 microgram dosage of MMC affected all layers of the retina.
Cell Proliferation ; Intravitreal Injections ; Mitomycin* ; Mitosis ; Rabbits ; Retina ; Retinaldehyde ; Vitreoretinopathy, Proliferative

The synovium is lined by a layer of intimal cells which have been classified on ultrastructural criteria into type A and B synoviocytes. The functionally important lining cells of the synovium(type A and B synoviocytes) are the subjects of many study but have presented problems with their characterization and microscopical identification. Synovial sarcoma is a distinct and generally recognized soft tissue tumor that its origin still raises controversy. In this study, 12 cases of nonspecifically proliferative and resting human synoviocytes have been obtained from the synovium of knee and hip joints, and 3 cases of synovial sarcoma which have arisen in the left thigh, left buttock and right inguinal region were examined with light microscopy, immunohistochemical observation, and electron microscopy. In light microscopic level, it was difficult to differentiate the type A synoviocytes from type B synoviocytes morphologically. The reactive type B synoviocytes were positive for the protein of cytoskeleton such as pancytokeratin, CK1, CK8, CEA, and vimentin. The resting type B synoviocytes showed positive reactions for pancytokeratin, CK1, and CK8. The markers for the monocytes/histiocytes(CD15, CD68, lysozyme, Al-AT, Al-ACT) were reactive in resting and reactive type A synoviocytes. Also, MHC class II antigen was reactive in type A synoviocytes. Three cases of primary synovial sarcoma were 2 fibrous monophasic and 1 biphasic. Spindle-shaped cell in fibrous monophasic synovial sarcoma showed reactivity for CK7 and pancytokeratin, and epithelial cells (lining the glands) in biphasic synovial sarcoma were reactive for CK 7, pancytokeratin, EMA, and focally CEA, but only spindle cells reactive for vimentin, By electron microscopy, fibrous monophasic synovial sarcoma showed pseudogland formation with intercellular junctions of paired subplasmalemmal density and discontinuous basal lamina. These results suggest that the reactive type B synoviocytes and synovial sarcoma show an aberrant expression of the vimentin and CEA. The expression of CK on the resting and reactive type B synoviocytes and fibrous monophasic and biphasic synovial sarcomas are different. Type A synoviocytes expressing the MHC class II molecule and monocyte/histiocyte markers suggest a member of the mononuclear phagocytic system. The reasons of the aberrant expression of the intermediate filament, vimentin and oncofetal antigen, and CEA in reactively proliferative type B synoviocytes and synovial sarcoma and the different expression of cytokeratin on the resting, reactive type B synoviocyte and synovial sarcoma should be further evaluated.
Basement Membrane ; Buttocks ; Cytoskeleton ; Epithelial Cells ; Hip Joint ; Histocompatibility Antigens Class II ; Humans* ; Immunohistochemistry ; Intercellular Junctions ; Intermediate Filaments ; Keratins ; Knee ; Microscopy ; Microscopy, Electron ; Muramidase ; Sarcoma, Synovial* ; Synovial Membrane ; Thigh ; Vimentin