No abstract available.
Osteomyelitis*

No abstract available.
Acidosis, Renal Tubular*

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.
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

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

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*

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

Epithelioid Hemangioendothelioma(EH) is a rare vascular tumor, originating from endothelial cells. The principal locations are lung, soft tissue, bone and liver. This tumor is of borderline malignancy, relatively benign course. In the lung, the tumor is often multifocal, bilateral and frequently lead to the mistaken diagnosis of metastatic carcinoma. Although EH of the lung is relatively slow growing tumor, extensive pulmonary involvement, systemic metastasis, mainly to the liver have been documented. A 26-year-old man with EH involving the lung and liver was reported. Chest X-ray and chest CT showed multiple nodules in both lung fields and Abdominal CT multiple round low densities in liver. Transbronchial lung biopsy was performed. The patient diagnosed as EH by light microscopic finding and immunohistochemical study for Factor VIII-related antigen.
Adult ; Biopsy ; Bone and Bones ; Diagnosis ; Endothelial Cells ; Hemangioendothelioma, Epithelioid* ; Humans ; Liver* ; Lung* ; Neoplasm Metastasis ; Thorax ; Tomography, X-Ray Computed ; von Willebrand Factor

BACKGROUND: We made a comparative study on the antiemetic effect of midazolam and ondansetron added to intravenous patient-controlled analgesia (PCA) using fentanyl with gynecologic patients undergoing pelviscopic surgery. METHODS: The PCA using 20 microg/kg of fentanyl was started in all groups postoperatively. A dose of 16 mg of ondansetron was added to the PCA of group O (n = 30). A dose of 5 mg of midazolam was added to the PCA of group M (n = 30). While 16 mg of ondansetron and 5 mg of midazolam were added to the PCA of group MO (n = 30). Total volume of the PCA was 60 ml, and the PCA system was programmed to deliver 0.5 ml/h of continuous doses and a 0.5 ml bolus on demand, with a 15 minutes lockout interval. The incidence of postoperative nausea and vomiting (PONV), sedation score, visual analog scale (VAS) for pain, and rescue drug dose for PONV were investigated at the postanesthesia care unit (PACU), 6 hours, and 24 hours after recovery. RESULTS: The incidence of PONV in group MO was significantly lower than in group O at PACU, 24 hours after recovery (P < 0.05). The sedation score and VAS pain score showed no differences among all groups. CONCLUSIONS: Midazolam added to PCA using fentanyl proved more effective than ondansetron in preventing PONV without adverse effects.
Analgesia, Patient-Controlled ; Antiemetics ; Fentanyl ; Humans ; Incidence ; Midazolam ; Ondansetron ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting