No abstract available.
Hypereosinophilic Syndrome*

Arthroscopic repair of an isolated teres minor tendon tear without associated shoulder joint pathology has not been reported in the literature. We report on a case of isolated teres minor tendon tear after trauma. The patient complained of severe shoulder pain and progressive limited range of motion 4 months after the injury. Magnetic resonance imaging showed a full-thickness tear of the teres minor tendon at its musculotendinous junction and arthroscopic repair was performed. At 2 years follow-up, satisfactory clinical and radiological outcomes were observed with return to pre-injury level. Here, the authors report this case and provide a review of literature.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Pathology ; Range of Motion, Articular ; Shoulder Joint ; Shoulder Pain ; Tears* ; Tendons*

No abstract available.
Echocardiography* ; Heart Defects, Congenital* ; Prenatal Diagnosis*

No abstract available.
Sarcoma* ; Uterus*

The statistical analysis is an essential procedure ensuring that the results of researches are based on evidences rather than opinion. The purpose of this study is to evaluate the statistical methods and errors in JKPRS and to propose improvement plan.We reviewed 326 articles published in JKPRS between 1996 and 1999. We evaluated the validity of used statistical methodology with our own checklist based on "Guideline for statistical reporting in articles for medical journals" by "International committee of medical journal editors". Among 326 articles, case(series) report and original articles were 167(51.2%) and 156(47.9%) respectively. In 159(48.8%) papers statistical method was not used. In 94 (28.8%) papers, only descriptive methods were used, while in 73 papers(22.4%) descriptive and inferential methods were used. The papers published in 1999 used more statistical methods than in 1996. Among the papers which used descriptive method, 90 papers(53.0%) showed appropriate central tendency and dispersion. But, in papers which used inferential method, 24 papers(33.0%) applied appropriate methods and only 4 papers(5.5%) were satisfactory in utilization of statistical methodology. It is suggested that more consultation of investigators with bio-statisticians, a basic training on statistical methods in resident programs, and more extensive statistical refereeing are needed.
Checklist ; Humans ; Research Personnel

Proteases in the skin are essential to epidermal permeability barrier homeostasis. In addition to their direct proteolytic effects, certain proteases signal to cells by activating protease-activated receptors (PARs), the G-protein-coupled receptors. The expression of functional PAR-2 on human skin and its role in inflammation, pruritus, and skin barrier homeostasis have been demonstrated. Atopic dermatitis (AD) is a multifactorial inflammatory skin disease characterized by genetic barrier defects and allergic inflammation, which is sustained by gene-environmental interactions. Recent studies have revealed aberrant expression and activation of serine proteases and PAR-2 in the lesional skin of AD patients. The imbalance between proteases and protease inhibitors associated with genetic defects in the protease/protease inhibitor encoding genes, increase in skin surface pH, and exposure to proteolytically active allergens contribute to this aberrant protease/PAR-2 signaling in AD. The increased protease activity in AD leads to abnormal desquamation, degradation of lipid-processing enzymes and antimicrobial peptides, and activation of primary cytokines, thereby leading to permeability barrier dysfunction, inflammation, and defects in the antimicrobial barrier. Moreover, up-regulated proteases stimulate PAR-2 in lesional skin of AD and lead to the production of cytokines and chemokines involved in inflammation and immune responses, itching sensation, and sustained epidermal barrier perturbation with easier allergen penetration. In addition, PAR-2 is an important sensor for exogenous danger molecules, such as exogenous proteases from various allergens, and plays an important role in AD pathogenesis. Together, these findings suggest that protease activity or PAR-2 may be a future target for therapeutic intervention for the treatment of AD.
Anti-Infective Agents/pharmacology ; Dermatitis, Atopic/*enzymology ; Endopeptidases/metabolism ; Homeostasis ; Humans ; Hydrogen-Ion Concentration ; Inflammation ; Models, Biological ; Models, Genetic ; Peptide Hydrolases/*metabolism ; Receptor, PAR-2/*metabolism ; Serine Proteases/metabolism ; Signal Transduction ; Skin/enzymology/pathology ; Treatment Outcome

PURPOSE: To evaluate the extrahepatic spread of peripheral cholangiocarcinoma with CT. MATERIALS AND METHODS: We retrospectively reviewed CT findings of extrahepatic spread in thirty-six patients with peripheral cholangiocarcinoma confirmed adenocarcinoma at surgery(n=5) or percutaneous biopsy(n--31) without primary leion in other organs, and analysed the frequency and distribution of enlarged lymph nodes, direct invasion of adjacent solid organs, and thrombosis of major vessels. RESULTS: Among the 36 cases, enlarged metastatic lymph node was noted in twenty-four(66.7%), direct invasion into adjacent organs in six(16.7%), portal and inferior vena caval thrombosis in five(13.9%). Enlarged lymph nodes were seen in hepatic nodes(n=16, 44.4%), portocaval nodes(n=15, 41.7%), interaortocaval nodes (n=10, 27.8) and celiac nodes in two(5.6%). Direct invasion was detected in the greater omentum(n=6), gallbladder(n:3) and stomach(n=2). Portal vein thrombosis(n:5) and thrombosis of inferior vena cava(n=2) were noted. CONCLUSION: Lymph node metastasis was seen in 67% in patients with peripheral cholangiocarcinoma. Direct invasion to adjacent organs and thrombosis in portal vein or inferior vena cava were occasionally associated.
Adenocarcinoma ; Cholangiocarcinoma* ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Portal Vein ; Retrospective Studies ; Thrombosis ; Vena Cava, Inferior

Purpose: To retrospectively compare the fixation methods for reattaching a trochanteric fragment in a pertrochanteric fracture treated with bipolar hemiarthroplasty. Materials and methods: Forty cases of an unstable femur pertrochanteric fracture were analyzed and followed up for average of 19(6~40) months. There were 18 cases fixed with tension band wiring (group 1), 7 cases treated using modified tension band wiring with K-wires (group 2) and 15 cases treated with the GTRD (Greater Trochanteric Reattachment Device) (group 3). Result: Group 1 was treated with simple a surgical procedure and the results were good. The second group had firm fixation postoperatively but required additional surgery in two cases to remove the K-wires because of wire migration after ambulation. Group 3 had relatively good results but required more dissection and a longer operating time. Conclusion: Tension band wiring or GTRD are good fixation methods for reattaching trochanteric fragments in pertrochanteric fractures. Moreover, tension band wiring is recommended for old osteoporotic patients due to a simple procedure and firm fixation. The use of modified tension band wiring using K-wire or a Steinmann-pin should not be used due to the possibility of distant migration.
Femur* ; Hemiarthroplasty* ; Humans ; Retrospective Studies ; Walking

BACKGROUND: Dexmedetomidine has been widely used during spinal anesthesia to provide sedation. However, dexmedetomidine frequently causes significant bradycardia. This study was designed to evaluate whether fluid loading could reduce the incidence of bradycardia after intravenous dexmedetomidine infusion in patients under spinal anesthesia. METHODS: A total of 99 patients, 18 to 65 years of age, with American Society of Anesthesiologists physical status 1 or 2, who were scheduled for elective total knee replacement or internal fixation of lower leg fracture under spinal anesthesia were enrolled. The patients were randomly assigned into one of the three groups, and fluid was loaded as follows: group LOW - 4 ml/kg, group MID - 8 ml/kg, and group HI - 12 ml/kg. After fluid loading and spinal anesthesia, dexmedetomidine was infused as follows: 1 μg/kg of loading dose for 10 minutes, thereafter continuous infusion at 0.4 μg/kg/h. RESULTS: The heart rate of group HI was significantly higher than that of group LOW (P = 0.049). The dosage of atropine administration was significantly lower in group HI than in group LOW (P = 0.003). The change in thoracic fluid contents was significantly higher in group HI than in group LOW (P = 0.018). CONCLUSIONS: Fluid loading during spinal anesthesia can reduce the incidence and extent of bradycardia after intravenous dexmedetomidine infusion.
Anesthesia, Spinal* ; Arthroplasty, Replacement, Knee ; Atropine ; Bradycardia* ; Dexmedetomidine* ; Fluid Therapy ; Heart Rate ; Humans ; Incidence ; Leg

Skin, as the outermost organ in the human body, continuously confronts the external environment and serves as a primary defense system. The protective functions of skin include UV-protection, anti-oxidant and antimicrobial functions. In addition to these protections, skin also acts as a sensory organ and the primary regulator of body temperature. Within these important functions, the epidermal permeability barrier, which controls the transcutaneous movement of water and other electrolytes, is probably the most important. This permeability barrier resides in the stratum corneum, a resilient layer composed of corneocytes and stratum corneum intercellular lipids. Since the first realization of the structural and biochemical diversities involved in the stratum corneum, a tremendous amount of work has been performed to elucidate its roles and functions in the skin, and in humans in general. The perturbation of the epidermal permeability barrier, previously speculated to be just a symptom involved in skin diseases, is currently considered to be a primary pathophysiologic factor for many skin diseases. In addition, much of the evidence provides support for the idea that various protective functions in the skin are closely related or even co-regulated. In this review, the recent achievements of skin researchers focusing on the functions of the epidermal permeability barrier and their importance in skin disease, such as atopic dermatitis and psoriasis, are introduced.
*Skin Physiology ; Skin Diseases/*metabolism/physiopathology ; Skin/*metabolism ; Permeability ; Humans ; Animals