No abstract available.
Osteomyelitis*

The use of interlocking intramedullary nail is accepted one of treatment choices in the comminuted fractures of humeral shaft. The insertion of distal interlocking screws remains technically problematic. The use of intrageon's hands during the procedure. In order to reduce technical difficulty and radiation exposure, it is necessary to compare the rigidity of intramedullary nail according to the number of distal interlocking screws. The purpose of study is to compare the stability of interlocking intramedullary nail according to the number of distal screws by means of torsional compliance measurements in the simulated humeral shaft fractures. Simulated fractures were made in 20 humora from 10 cadavera at the mid-junction of humeral shaft. All humora were fixated with titaium humeral nail system. Interlocking screws were placed at proximal and distal screw holes by standard procedure. Group I consisted of 10 humora fixated with one distal interlocking screw and group II consisted of 10 humora fixated with two distal intterlocking screws. Torsional compliance was measured with single-end of 10 humora fixated with two distal interlocking screws. Torsional compliance was measured with single-end double arm torquing machine. The torsional compliance analog was 0.0294+/-0.0033 mm/N mm for one screw and 0.0241+/-0.0045 mm/N mm for two distal screws. The torsional compliance analog between two groups was found to be statistically insignificant(p=0.23). In conclusion, One distal interlocking screw was not inferior to two interlocking screws in terms of biomechanical characteristics, especially torsional compliance analog.
Arm ; Compliance ; Fracture Fixation, Intramedullary* ; Fractures, Comminuted ; Hand

No abstract available.
Acidosis, Renal Tubular*

No abstract available.
Adult* ; Humans ; Immunosuppressive Agents* ; Nephrotic Syndrome*

PURPOSE: To report the outcome of using expandable metallic stent in the management of malignanttracheobronchial stenosis with dyspnea. MATERIALS AND METHODS: Under fluoroscopic and bronchoscopic guidance,seven patients with malignant airway stenosis were treated with ten expandable metallic stents. The cause ofstenosis was metastasis from esophageal cancer in five patients, recurrent adenoid cystic carcinoma of the tracheain one, and primary lung cancer in one. The major sites of obstruction were the trachea in four patients, the leftmain bronchus in one, the trachea and left main bronchus in one, and the trachea and both bronchi in one. Chestradiography(n=7), bronchoscopy(n=5), pulmonary function test(PFT)(n=3), and spirometry(n=1) were performed beforeand after stent placement. RESULTS: In all seven patients, the stent was successfully placed at the lesion sitesand dyspnea began to improve immediately. After the procedure, chest radiography and bronchoscopy showed anincrease in airway diameter. After stent placement, forced vital capacity (FVC) and forced expiratory volume inone second(FEV1) improved 53% and 56%, respectively. Peak flow velocity also changed from 46 L/min to 200 L/min.During median follow-up of 67(41-1565)days, one stent migration occurred. In one patient, proximal tumorovergrowth occurred, and in one, tumor ingrowth was treated with balloon dilatation. CONCLUSION: For in thepalliative treatment of malignant tracheobronchial stenosis with dyspnea, placement of expandable metal steuts issafe and effective.
Bronchi ; Bronchoscopy ; Carcinoma, Adenoid Cystic ; Constriction, Pathologic* ; Dilatation ; Dyspnea ; Esophageal Neoplasms ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Lung Neoplasms ; Neoplasm Metastasis ; Palliative Care* ; Radiography ; Stents* ; Thorax ; Trachea ; Vital Capacity

PURPOSE: To investigate the problems of the Hanaro stent (Solco Intermed, Seoul, Korea) when used in the palliative treatment of patients with inoperable malignant biliary obstruction. MATERIALS AND METHODS: Between January 2000 and May 2001, the treatment of 46 patients with malignant biliary obstruction involved percutaneous placement of the Hanaro stent. Five patients encountered problems during removal of the stent's introduction system. The causes of obstruction were pancreatic carcinoma (n=2), cholangiocarcinoma (n=2), and gastric carcinoma with biliary invasion (n=1). In one patient, percutaneous transhepatic cholangiography and stent insertion were performed as a one-step procedure, while the others underwent conventional percutaneous transhepatic biliary drainage for at least two days prior to stent insertion. A self-expandable Hanaro stent, 8-10 mm in deameter and 50-100 mm in lengh, and made from a strand of nitinol wire, was used in all cases. RESULTS: Among the five patients who encountered problems, breakage of the olive tip occourred in three, upward displacement of the stent in two, and improper expansion of the distal portion of the stent, unrelated with the obstruction site, in one. The broken olive tip was pushed to the duodenum in two cases and to the peripheral intrahepatic duct in one. Where the stent migrated during withdrawal of its introduction system, an additional stent was inserted. In one case, the migrated stent was positioned near the liver capsule and the drainage catheter could not be removed. CONCLUSION: Although the number of patients in this study was limited, some difficulties were encountered in withdrawing the stent's introduction system. To prevent the occurrence of this unusual complication, the stent should be appropriately expansile, and shape in the olive tip shoud be considered.
Catheters ; Cholangiocarcinoma ; Cholangiography ; Drainage ; Duodenum ; Humans ; Liver ; Olea ; Palliative Care ; Seoul ; Stents*

OBJECTIVES: We examined the levels of IL-1 , IL-6, TNF- , and IFN-gamma in peripheral blood mononuclear cells (PBMC) supernatants of kidney allograft recipients and also investigated the effect of PBMC supernatants on the expressions of HLA Class II antigen and ICAM-1 on endothelial cells. METHODS: PBMC were harvested before grafting, at steady state after grafting (serum creatinine < 2.0 mg/dL), at the onset of acute rejection episodes, and at steady state after rescue from acute rejection episodes. At each step, we examined the levels of cytokines in PBMC supernatants and investigated supernatants induced HLA class II antigen and ICAM-1 expression on cultured umbilical venous endothelial cells. RESULTS: HLA class II antigen and ICAM-1 expression were higher in endothelial cells stimulated with PBMC supernatants from uremic hemodialysis patients (N=10) than from control subjects (N=8). The levels of IL-1 , IL-6, TNF- , and IFN-gamma in PBMC supernatants were higher in uremic hemodialysis patients than in control subjects. In steady state after grafting, significant reductions in the PBMC supernatants induced HLA class II antigen and ICAM-1 expression on endothelial cells and the levels of these cytokines were found. In graft recipients who underwent rejection (N=5), cytokine production by PBMC and PBMC supernatants induced HLA class II antigen and ICAM-1 expression increased at the time of rejection and decreased after treatment of rejection but not significant. CONCLUSION: Cytokine production by PBMC and PBMC supernatants induced HLA class II antigen and ICAM-1 expression were higher in uremic hemodialysis patients than in normal controls. They significantly decrease in steady state after grafting and immunosuppressive therapy was considered as a major factor responsible for that. Further studies ,however, are still required to clarify the roles of cytokines, HLA class II antigen, and ICAM-1 in a series of allograft rejection process.
Allografts ; Creatinine ; Cytokines ; Endothelial Cells ; Histocompatibility Antigens Class II* ; Humans ; Intercellular Adhesion Molecule-1* ; Interleukin-1 ; Interleukin-6 ; Kidney ; Kidney Transplantation* ; Renal Dialysis ; Transplants

BACKGROUND: Distraction osteogenesis (DO) is a useful method for treating cases demanding the generation of new bone. During DO, the angiogenic activity is crucial factor in the new bone formation. The aim of this study was to detect the autocrine growth activity in the cellular components of the distracted bone with observation of the co-expression of vascular endothelial growth factor (VEGF) and its receptors following the mandibular DO. MATERIALS AND METHODS: Unilateral mandibular distraction (0.5 mm twice per day for 10 days) was performed in six mongrel dogs. Two animals were killed at 7, 14, and 28 days after completion of distraction, respectively. Immediately after the animals were killed, the right mandibles were harvested en block. Immunohistochemical staining was processed for observation of the VEGF expression, and double immunofluorescent staining was also processed for detection of the co-expression of osteocalcin and VEGF's two distinct receptors (VEGFR-1 and VEGFR-2). RESULTS: At 7 and 14 days after distraction, the expressions of VEGF were significantly increased in the osteogenic cells of the distracted bone. Up to 28 days after distraction, VEGF was still expressed moderate in the osteoblastic cells of distracted bone. The co-expressions of osteocalcin / VEGFR-1 and osteocalcin / VEGFR-2 were observed in the distracted bone at 7 and 14 days after distraction. In the double immunofluorescent staining, the co-expression's level of osteocalcin / VEGFR-1 was more than that of osteocalcin / VEGFR-2. Conclusion: Taken together, this study suggested that VEGF plays an important role in the osteogenesis, and these osteoblastic cell-derived VEGF might act as autocrine growth factor during distraction osteogenesis. In the other word, the cellular components, such as osteoblasts and immature fibroblast-like cellsor mesenchymal cells in the distracted bone, might have autocrine growth activity during distraction osteogenesis.
Animals ; Dogs ; Mandible ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Osteogenesis, Distraction* ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factor Receptor-1 ; Vascular Endothelial Growth Factor Receptor-2

BACKGROUND: An elevated plasma plasminogen activator inhibitor-1 (PAI-1) concentration has been identified as a factor for the development of macroangiopathy including myocardial infarction, and an association between polymorphism of the PAI-1 promoter and plasma PAI-1 levels has been described. PAI-1 gene is thought to be one of candidate genes in development of diabetic nephropathy. We studied association between polymorphism of PAI-1 promoter and the development of diabetic renal failure in type 2 DM. METHODS: We reviewed the past clinical records of 4, 500 diabetic patients who were registered in KyungHee university hospital. We selected 85 diabetic patients without nephropathy for more than 10 years and 92 diabetic patients in which Kidney failure was developed within 20 years. We investigated promoter -675 and -844 region polymorphisms in type 2 DM patients with ESRD compared with patients without nephropathy by using PCR-RLFP. RESULTS: The genotypes of group of type 2 DM with ESRD and control group were consistent with Hardy-Weingerg equation. There was no significant difference between two groups in the polymorphisms of PAI-I promoter -675 region. Similarly, there was no significant difference between two groups in the polymorphisms of PAI-I promoter -844 region. CONCLUSION: The results suggest that the polymorphisms of PAI-1 gene are not associated with development of diabetic renal failure in Korean patients with type 2 DM.
Diabetic Nephropathies ; Genotype ; Humans ; Kidney Failure, Chronic ; Myocardial Infarction ; Plasma ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators* ; Plasminogen* ; Renal Insufficiency*

Bile acids and their synthetic derivatives induced apoptosis in various kinds of cancer cells and anticancer effects. It has been reported that the synthetic chenodeoxycholic acid (CDCA) derivatives showed apoptosis-inducing activity on various cancer cells in vitro. It wasn't discovered those materials have apoptosis-inducing effects on G361 human melanoma cells. The present study was done to examine the synthetic bile acid derivatives, HS-1199 and HS-1200, induced apoptosis on G361 cells and such these apoptosis events. The viability of G361 cells was assessed by the MTT assay. Induction of apoptosis was confirmed by DNA electrophoresis and Hoechst staining. Westen blot analysis and immunofluorescent staining were performed to study the alterations in expression level and translocation of apoptosis-related proteins. Proteasome activity and mitochondrial membrane potential (MMP) change were also assayed. Tested G361 cells showed several lines of apoptotic manifestation such as activation of caspase-3, DFF and PARP, DNA degradation (HS-1200 only), nuclear condensation, inhibition of proteasome activity, reduction of mitochondrial membrane potential, and the release of cytochrome c and AIF to cytosol. Between two synthetic derivatives, HS-1200 showed stronger apoptosis-inducing effect than HS-1199 did. Taken collectively, we here demonstrated for the first time that synthetic CDCA dedrivatives induce apoptosis of human melanoma cells through the proteasome, mitochondria and caspase pathway. Therefore our data provide the possibility that HS-1200 could be considered as a novel therapeutic strategy for human melanoma cells from its powerful apoptosis-inducing activity.
Apoptosis* ; Bile ; Bile Acids and Salts ; Caspase 3 ; Chenodeoxycholic Acid* ; Cytochromes c ; Cytosol ; DNA ; Electrophoresis ; Humans* ; Melanoma* ; Membrane Potential, Mitochondrial ; Mitochondria ; Proteasome Endopeptidase Complex